Bone turnover markers in epileptic patients under chronic valproate therapy

Background: The effects of chronic valproic acid administration on bone health have been a matter of concern and controversy. In this study, the bone status following valproate intake was assessed by using several bone-related biochemical markers. Materials and Methods: In this case-control study, 62 epileptic patients and 40 age-and gender-matched controls were enrolled. The patients had been under chronic valproate therapy (758 +/- 29 mg/day) for at least the past 6 months, without any vitamin D/or calcium supplementation. Serum markers of bone turnover (carboxy-terminal telopeptide of type I collagen (CTX) and bone-specific alkaline phosphatase [BALP]), calcium, phosphorus, total alkaline phosphatase, and parathyroid hormone levels were measured in both groups. Results: The markers of bone turnover as well as other measured bone biochemical parameters did not statistically differ between the two groups. Conclusion: Valproate therapy at the mentioned doses does not seem to change bone turnover in adult epileptic patients.