Comprehensive insights into bone health, hormonal patterns, and fracture risks among men with drug resistant epilepsy: a crucial evaluation
Abstract
Objective: To evaluate bone density and microstructure, fragility fractures, and hormones in men 50 years and older receiving antiseizure medications (ASMs).
Subjects and methods: Study population included 39 men with difficult-to-control epilepsy and 42 healthy men as control group. Spine and hip areal bone mineral density (aBMD), body composition and vertebral fracture assessment (VFA) were evaluated using Dual-Energy X-Ray Absorptiometry (DXA). Volumetric bone mineral density (vBMD) and microarchitecture of trabecular and cortical compartments were evaluated using High-Resolution Peripheral Quantitative Computed Tomography (HR-pQCT). Physical activity was tested by the International Physical Activity Questionnaire (IPAQ). The fracture risk was estimated by fracture risk assessment tool (FRAX).
Results: ASMs patients showed lower cortical bone thickness (Ct.Th) in distal tibia (1.196 ± 0.295 vs. 1.341 ± 0.241 mm, p = 0.03), more fractures (12 vs. 2, p = 0.003) mostly morphometric vertebral fractures, and a higher risk for major and hip fractures based on FRAX. Hormonal changes included higher median parathyroid hormone (PTH) (50.4 vs. 24 pg/mL, p < 0.001) possibly associated with vitamin D insufficiency, (25(OH)D levels below 30 ng/mL in 43.6% of ASMs patients), lower median Estradiol that was an independent factor for fractures (p = 0.04) and bioavailable Testosterone in the lowest quartile in 52 % of them.
Conclusion: Men on ASMs exhibit lower Ct.Th and hormone changes…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 42 participants or records.
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