Increased circulating levels of γ-carboxyglutamic acid-containing protein and decreased bone mass in children on anticonvulsant therapy |
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| Authors: | Noritaka Takeshita Yutaka Seino Hitoshi Ishida Yoshiki Seino Hiroyuki Tanaka Chiharu Tsutsumi Katsumi Ogata Keizi Kiyohara Hiroshi Kato Masumi Nozawa Yasuhiro Akiyama Kuniko Hara Hiroo Imura |
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| Affiliation: | (1) Division of Metabolism and Clinical Nutrition, Kyoto University School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, Japan;(2) Department of Pediatrics, Osaka University School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, 606 Osaka, Japan;(3) Department of Nutrition, School of Health Science, Faculty of Medicine, University of Tokyo, 54 Shogoin Kawahara-cho, Sakyo-ku, 606 Tokyo, Japan;(4) Matsubase Ryogoen, 54 Shogoin Kawahara-cho, Sakyo-ku, 606 Kumamoto, Japan;(5) Department of Orthopaedic Surgery, Saitama Medical School, 54 Shogoin Kawahara-cho, Sakyo-ku, 606 Saitama, Japan;(6) Department of Surgery, Josai Dental University, 54 Shogoin Kawahara-cho, Sakyo-ku, 606 Saitama, Japan;(7) Department of Pharmacology, Tokyo Research Laboratories, Eisai Co., Ltd., 54 Shogoin Kawahara-cho, Sakyo-ku, 606, Japan |
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| Abstract: | Summary In order to investigate the pathophysiology of anticonvulsant-induced osteopenia, circulating levels of bone γ-carboxyglutamic acid-containing protein (Bone Gla Protein: BGP) and urinary excretion of BGP were measured in 16 chidren on chronic anticonvulsant therapy and in 12 control children. Using microdensitometry analysis, osteopenia was found in 25% of the anticonvulsant therapy group, but it was not observed in the control group. Serum BGP and A1-P levels were significantly increased in the anticonvulsant group compared with the control group (P<0.05 andP<0.01, respectively), and a positive correlation was found between serum BGP and A1-P levels (P<0.05). Urinary excretion of BGP and hydroxyproline showed an increase in the anticonvulsant group, but it was not statistically significant. On the other hand, there was no significant difference between the two groups in serum levels of vitamin D metabolites, PTH, calcitonin, Ca, or P or in urinary excretion of Ca or P. It is suggested, therefore, that the increased BGP level in children receiving anticonvulsant therapy is a reflection of high bone turnover due to anticonvulsant drug complications. |
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| Keywords: | BGP Anticonvulsant therapy Osteopenia Bone turnover |
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