Text Box: SERUM OSTEOCALCIN AND URINARY DEOXYPYRIDINOLINE ARE USEFUL MARKERS FOR EARLY DETECTION OF BONE METABOLISM IN CHILDREN WHO RECEIVED ANTIEPILEPTIC DRUGS
Choi EK, Jung JM, Kim SJ, Cho SC
Department of Pediatrics, Chonbuk National University, Chonju, Korea

Objective: This study was performed to evaluate the influence of antiepileptics on the bone metabolism in pediatric patients who received antiepileptics and method for the early detection of adverse bone metabolism.
Methods: Forty-eight epileptic patients were enrolled in this study. All subjects were taken antiepileptics at least for 6 months. Subjects were grouped according to the antiepileptics used: Group I was treated with carbamazepine (CBZ); Group II received valproic acids (VPA); Group III received multi-drugs including CBZ and VPA. We determined serum osteocalcin and total alkaline phosphatase levels as markers of bone formation, and urinary deoxypyridinoline as a marker of bone resorption. Blood and urine samples were collected before the initial medication and follow up at least 6 months later.
Results: Concentrations of serum osteocalcin and urinary deoxypyridinoline were significantly increased in the CBZ treated group compared with controls. The increment of deoxypyridinoline positively correlated with the duration of treatment, especially in children who received CBZ therapy for more than 12 months (P<0.05). The serum concentrations of calcium, phosphorus were within normal ranges, but the levels of alkaline phosphatase were more significantly increased in all groups than in control (P<0.05). 
Conclusion: Our data suggest that serum osteocalcin, alkaline phosphatase and urinary deoxypyridinoline may be useful markers for the early detection of harmful bone metabolism during antiepileptic treatment.
2425