Hyponatremia and metabolic bone disease in patients with epilepsy

Diemar, Sarah Seberg; Sejling, Anne‐Sophie; Eiken, Pia; Suetta, Charlotte; Jørgensen, Niklas Rye; Andersen, Noémi Becser

doi:10.1016/j.bone.2019.03.017

Cited by 9 publications

(9 citation statements)

References 47 publications

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“…According to a study by Diemar et al, moderate and severe hyponatremia were associated with osteoporosis. 37 Hyponatremia was not found in our study. As expected, we found a significant reduction in Mg values during the study period due to a lower level of PTH.…”

Section: Discussioncontrasting

confidence: 70%

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Substantial early changes in bone and calcium metabolism among adult pharmacoresistant epilepsy patients on a modified Atkins diet

et al. 2022

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Objective:The aim of this study was to investigate whether the modified Atkins diet (MAD), a variant of the ketogenic diet, has an impact on bone-and calcium (Ca) metabolism.Methods: Two groups of adult patients with pharmacoresistant epilepsy were investigated. One, the diet group (n = 53), was treated with MAD for 12 weeks, whereas the other, the reference group (n = 28), stayed on their habitual diet in the same period. All measurements were performed before and after the 12 weeks in both groups. We assessed bone health by measuring parathyroid hormone (PTH), Ca, 25-OH vitamin D (25-OH vit D), 1,25-OH vitamin D (1,25-OH vit D), phosphate, alkaline phosphatase (ALP), and the bone turnover markers procollagen type 1 N-terminal propeptide (P1NP) and C-terminal telopeptide collagen type 1 (CTX-1). In addition, we examined the changes of sex hormones (estradiol, testosterone, luteinizing hormone, follicle-stimulating hormone), sex hormonebinding globulin, and leptin.Results: After 12 weeks of MAD, we found a significant reduction in PTH, Ca, CTX-1, P1NP, 1,25-OH vit D, and leptin. There was a significant increase in 25-OH vit D. These changes were most pronounced among patients <37 years old, and in those patients with the highest body mass index (≥25.8 kg/m²), whereas sex and type of antiseizure medication had no impact on the results. For the reference group, the changes were nonsignificant for all the analyses. In addition, the changes in sex hormones were nonsignificant.Significance: Twelve weeks of MAD treatment leads to significant changes in bone and Ca metabolism, with a possible negative effect on bone health as a result. A reduced level of leptin may be a triggering mechanism. The changes could be important for patients on MAD, and especially relevant for those patients who receive treatment with MAD at an early age before peak bone mass is reached.

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Section: Discussioncontrasting

confidence: 70%

“…According to a study by Diemar et al, moderate and severe hyponatremia were associated with osteoporosis 37 . Hyponatremia was not found in our study.…”

Section: Discussioncontrasting

confidence: 55%

Substantial early changes in bone and calcium metabolism among adult pharmacoresistant epilepsy patients on a modified Atkins diet

et al. 2022

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“…For some patients polytherapy is the only way to achieve sufficient seizure control and hence cannot be avoided. However, different types of AEDs are currently available and guidelines could help in combining AEDs in order to optimize seizure control while minimizing adverse effects, for example the risk of decreasing BMD [11,16].…”

Section: Discussionmentioning

confidence: 99%

“…Experiments and procedures were done in alignment with the Helsinki Declaration of 1975 (revised 2013). Demographic information and the T-scores of their DXA scans for lumbar spine L 1 -L 4 , and lowest femoral neck and total hip for this subpopulation has previously been published [11].…”

Section: Study Design and Patient Demographicsmentioning

confidence: 99%

Metabolic bone disease in patients with epilepsy and the use of antiepileptic drugs – Insight from a Danish cross-sectional study

Baddoo

Mills

Kullab

et al. 2021

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“…Patients with epilepsy have increased risk of developing osteoporosis and increased fracture risk that is 2-6 times higher than the general population, independent of seizurerelated fractures (Diemar et al, 2019a). Decreased exercise, a more sedentary indoor lifestyle, and use of anti-epileptic drugs (AEDs), which can lead to impaired coordination and disrupted calcium/vitamin D metabolism, may contribute to poor bone health (Kobau et al, 2004;Shellhaas and Joshi, 2010;Diemar et al, 2019b). A meta-analysis of epileptic children showed a significant BMD decrease at lumbar spine, trochanter, femoral neck, and total body regions (Zhang et al, 2015).…”

Section: Epilepsymentioning

confidence: 99%

Effects of Neurological Disorders on Bone Health

2020

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Neurological diseases, particularly in the context of aging, have serious impacts on quality of life and can negatively affect bone health. The brain-bone axis is critically important for skeletal metabolism, sensory innervation, and endocrine cross-talk between these organs. This review discusses current evidence for the cellular and molecular mechanisms by which various neurological disease categories, including autoimmune, developmental, dementia-related, movement, neuromuscular, stroke, trauma, and psychological, impart changes in bone homeostasis and mass, as well as fracture risk. Likewise, how bone may affect neurological function is discussed. Gaining a better understanding of brain-bone interactions, particularly in patients with underlying neurological disorders, may lead to development of novel therapies and discovery of shared risk factors, as well as highlight the need for broad, whole-health clinical approaches toward treatment.

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Hyponatremia and metabolic bone disease in patients with epilepsy

Cited by 9 publications

References 47 publications

Substantial early changes in bone and calcium metabolism among adult pharmacoresistant epilepsy patients on a modified Atkins diet

Substantial early changes in bone and calcium metabolism among adult pharmacoresistant epilepsy patients on a modified Atkins diet

Metabolic bone disease in patients with epilepsy and the use of antiepileptic drugs – Insight from a Danish cross-sectional study

Effects of Neurological Disorders on Bone Health

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