Vitamin D deficiency in a Portuguese epilepsy cohort: who is at risk and how to treat

被引:10
作者
Cunha, Ines Antunes [1 ]
Saraiva, Ana M. R. [2 ]
Lopes, Pedro [1 ]
Jesus-Ribeiro, Joana [1 ]
Duarte, Catia [3 ]
Leitao, Fatima [4 ]
Sales, Francisco [1 ]
Santana, Isabel [1 ,2 ]
Bento, Conceicao [1 ]
机构
[1] Coimbra Univ & Hosp Ctr, Neurol Dept, P-3004561 Coimbra, Portugal
[2] Univ Coimbra, Fac Med, Coimbra, Portugal
[3] Coimbra Univ & Hosp Ctr, Rheumatol Dept, Coimbra, Portugal
[4] Coimbra Univ & Hosp Ctr, Clin Pathol Dept, Coimbra, Portugal
关键词
enzyme-inducing antiepileptic drugs; sun exposure; obesity; seizures; cholecalciferol treatment; ANTIEPILEPTIC DRUG; BONE HEALTH; D SUPPLEMENTATION; ILAE COMMISSION; PREVENTION; FRACTURES; ADULTS;
D O I
10.1684/epd.2021.1268
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective. The epilepsy-related risk factors for vitamin D deficiency, particularly the use of enzyme-inducing antiepileptic drugs (EIAEDs), and how to treat vitamin D deficiency in patients with epilepsy remain unclear. Our aims were to explore risk factors and the influence of EAIEDs in vitamin D status and to determine the efficacy of a daily dose of oral cholecalciferol (vitamin D3) in epileptic patients with vitamin D deficiency. Methods. Clinical data were collected and 25-hydroxyvitamin D (25(OH)D) serum levels were measured. All patients with vitamin D deficiency (25(OH)D <=.20 ng/mL) or insufficiency (25(OH)D from 21-29 ng/mL) were treated with 6,670 IU/day cholecalciferol for eight weeks and 25(OH)D was then remeasured. Descriptive and inferential statistics were employed. Results. A total of 92 patients (44.6% males), with mean age of 41.0 +/- 14.8 years, were included. Measurements of 25(OH)D revealed that 79.3% patients had abnormal levels: 56.5% were vitamin D deficient and 22.8% were vitamin D insufficient. The statistically significant risk factors for vitamin D deficiency identified were: number of AEDs, treatment with EIAEDs, low sun exposure, high body mass index (BMI) and a high frequency of epileptic seizures. After treatment, 25(OH)D mean level increased by 98.99% (regardless of EIAED use or being overweight). Significance. In our sample, more than half of the adults with epilepsy showed 25(OH) D deficiency. Patients on EIAEDs had lower 25(OH)D levels. A daily dose of 6,670 IU cholecalciferol successfully led to the correction of 25(OH)D levels. A higher dose in obese patients or in patients taking EIAEDs may not be warranted and this should be considered in future guidelines for routine vitamin D deficiency treatment.
引用
收藏
页码:291 / 298
页数:8
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