THE CORRELATION OF LONG-TERM COMBINATION TREATMENT OF VALPROIC ACID AND TOPIRAMATE ON SERUM VITAMIN D LEVELS AMONG CHILDREN WITH EPILEPSY

Hexanto Muhartomo, M. Widiastuti, Endang Kustiowati, A. Bintoro, Arinta Puspita Wati, A. Putranti, R. P. Sinaga
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Abstract

Background: Epilepsy is a chronic condition characterized by unprovoked seizure. Vitamin D is necessary in child development process and is strongly influenced by the presence of anti-epileptic drugs.Objective: To determine the correlation of treatment duration and serum vitamin D levels in children with epilepsy who use the combination of valproic acid and topiramateMethods: A cross sectional study among forty pediatric patients with epilepsy with age range of 5-10 years at Dr. Kariadi Hospital Semarang. Examination of serum vitamin D levels is done by ELISA. Statistical analysis using Spearman correlation test and partial correlation test with significance level p = 0.05.Results: The mean of serum vitamin D levels in patient with combination treatment after 24 months was 21.87±1.21ng/ml, in those who still having seizure was 27.94±2.40ng/ml, and among who received delayed therapy was 23.23±2.07ng/ml. Bivariate analysis depicted that there was negative correlation between duration of treatment (rho= -0.850, p<0.001), onset of therapy (rho=0.604, p<0.001) and seizure frequency (rho=0.559, p<0.001) with serum vitamin D levels. Partial correlation analysis showed a significant correlation between duration of treatment and serum vitamin D levels after adjusted by onset of therapy (rho=-0.839, p<0.001) and seizure frequency (rho=-0.856, p<0.001).Conclusion: There is a correlation between the duration of treatment and serum vitamin D levels among children with epilepsy
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丙戊酸与托吡酯长期联合治疗对癫痫患儿血清维生素d水平的影响
背景:癫痫是一种以无端发作为特征的慢性疾病。维生素D在儿童发育过程中是必需的,并且受到抗癫痫药物的强烈影响。目的:探讨丙戊酸联合托吡酯治疗癫痫患儿治疗时间与血清维生素D水平的相关性。方法:对三宝朗Dr. Kariadi医院40例5-10岁儿童癫痫患者进行横断面研究。血清维生素D水平检测采用ELISA法。统计学分析采用Spearman相关检验和偏相关检验,显著性水平p = 0.05。结果:联合治疗24个月后患者血清维生素D水平平均值为21.87±1.21ng/ml,仍有癫痫发作者血清维生素D水平平均值为27.94±2.40ng/ml,延迟治疗者血清维生素D水平平均值为23.23±2.07ng/ml。双变量分析显示,治疗持续时间(rho= -0.850, p<0.001)、治疗开始时间(rho=0.604, p<0.001)和癫痫发作频率(rho=0.559, p<0.001)与血清维生素D水平呈负相关。偏相关分析显示,治疗持续时间与经治疗开始调整后的血清维生素D水平(rho=-0.839, p<0.001)和癫痫发作频率(rho=-0.856, p<0.001)具有显著相关性。结论:癫痫患儿治疗时间与血清维生素D水平存在相关性
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