Vitamin D supplementation and bone markers in ambulatory children on long-term valproic acid therapy. A prospective...

Area of Science:

• Pediatric Endocrinology
• Neurology
• Bone Metabolism

Background:

• Long-term valproic acid (VPA) therapy is used for epilepsy in children and adolescents.
• VPA therapy may adversely affect bone biochemical markers.
• Vitamin D supplementation is being investigated for potential benefits.

Purpose of the Study:

• To investigate the adverse effects of long-term VPA therapy on bone biochemical markers in children with epilepsy.
• To assess the benefits of vitamin D supplementation on these bone markers.

Main Methods:

• Prospective interventional study involving 54 ambulatory children on VPA monotherapy.
• Assessed 25-hydroxyvitamin D (25OHD), Crosslaps (CTX), total alkaline phosphatase (tALP), osteoprotegerin (OPG), and RANK ligand (sRANKL) before and after one year of vitamin D (400 IU/d) supplementation.
• Compared levels with healthy controls.

Main Results:

• Nearly half of VPA patients had insufficient/deficient 25OHD levels compared to controls.
• Vitamin D supplementation significantly increased 25OHD levels.
• Serum CTX and tALP showed a decreasing trend towards control levels after vitamin D intake.
• OPG and sRANKL levels did not change significantly and showed no difference from controls.
• A positive correlation between 25OHD and OPG emerged after supplementation.

Conclusions:

• Long-term VPA therapy is associated with increased bone turnover in pediatric epilepsy patients.
• Vitamin D supplementation appears to decrease elevated bone turnover markers.
• Vitamin D supplementation may offer benefits for bone health in children on long-term VPA therapy.