Vitamin D Deficiency in Pediatric Patients Using Antiepileptic Drugs: Systematic Review with Meta-analysis

Overview

Journal J Pediatr (Rio J)

Specialty Pediatrics

Date 2020 Mar 16

PMID 32171475

Citations 7

Authors

Cintia Junges

Tania Diniz Machado

Paulo Ricardo Santos Nunes Filho

Rudimar Riesgo

Elza Daniel de Mello

Affiliations

Soon will be listed here.

Abstract

Objectives: To measure the prevalence of vitamin D deficiency (through the 25-hydroxyvitamin D metabolite) in pediatric patients using antiepileptic drugs.

Source Of Data: Meta-analysis of studies identified through search in the PubMed, Embase, LILACS, and Cochrane Library databases, on February 19, 2019.

Summary Of Data: A total of 748 articles were identified, 29 of which were relevant to the objectives of this study. The prevalence of vitamin D deficiency found was 0.32 (95% CI=0.25-0.41; I=92%, p<0.01). In the subgroup analyses, the most significant results were observed in the group of patients using cytochrome P450-inducing antiepileptic drugs, with a prevalence of 0.33 (95% CI=0.21-0.47; I=86%, p<0.01) and, considering the study design, in the subgroup of cohort studies, with a prevalence of 0.52 (95% CI=0.40-0.64; I=76%, p<0.01).

Conclusions: Taking into account the deleterious effects of vitamin D deficiency on the bone health of individuals using antiepileptic drugs, it is suggested to include in their care 25-hydroxyvitamin D monitoring, cholecalciferol supplementation, and treatment of the deficiency, when present.

Citing Articles

Vitamin D status of pediatric epilepsy patients and evaluation of affecting factors.

Bilge S, Taskin S Ital J Pediatr. 2025; 51(1):39.

PMID: 39924499 PMC: 11809102. DOI: 10.1186/s13052-025-01898-9.

Hypovitaminosis D in university workers in Southern Ecuador: interactions between gender and lifestyle.

Diaz P, Cadena M, Montalvan M, Garrochamba K, Calderon P, Carrion G Front Nutr. 2024; 11:1482910.

PMID: 39391680 PMC: 11464991. DOI: 10.3389/fnut.2024.1482910.

Causal links between serum micronutrients and epilepsy: a Mendelian randomization analysis.

Chen H, Zheng Z, Cai X, Gao F Front Neurol. 2024; 15:1419289.

PMID: 39076846 PMC: 11284170. DOI: 10.3389/fneur.2024.1419289.

Comparison of 25-hydroxy vitamin D serum levels among children with epilepsy in therapy with single versus multiple antiseizure medications.

Gunawan P, Rochmah N, Faizi M Epilepsy Behav Rep. 2023; 24:100620.

PMID: 37680766 PMC: 10481176. DOI: 10.1016/j.ebr.2023.100620.

Prevalence and Related Risk Factors of Vitamin D Deficiency in Saudi Children with Epilepsy.

Al Khalifah R, Hamad M, Hudairi A, Al-Sulimani L, Al Homyani D, Al Saqabi D Children (Basel). 2022; 9(11).

PMID: 36360424 PMC: 9688346. DOI: 10.3390/children9111696.

References

Razazizan N, Mirmoeini M, Daeichin S, Ghadiri K . Comparison of 25-hydroxy vitamin D, calcium and alkaline phosphatase levels in epileptic and non-epileptic children. Acta Neurol Taiwan. 2014; 22(3):112-6. View

Attilakos A, Dinopoulos A, Paschalidou M, Tsirouda M, Karalexi M, Prasouli A . Long-term effect of levetiracetam monotherapy on haematological parameters in children with epilepsy: A prospective study. Epilepsy Res. 2018; 145:160-162. DOI: 10.1016/j.eplepsyres.2018.07.001. View

Mansbach J, Ginde A, Camargo Jr C . Serum 25-hydroxyvitamin D levels among US children aged 1 to 11 years: do children need more vitamin D?. Pediatrics. 2009; 124(5):1404-10. PMC: 3765249. DOI: 10.1542/peds.2008-2041. View

Krishnamoorthy G, Karande S, Ahire N, Mathew L, Kulkarni M . Bone metabolism alteration on antiepileptic drug therapy. Indian J Pediatr. 2009; 76(4):377-83. DOI: 10.1007/s12098-009-0005-5. View

Turan M, Cayir A, Ozden O, Tan H . An examination of the mutual effects of valproic acid, carbamazepine, and phenobarbital on 25-hydroxyvitamin D levels and thyroid function tests. Neuropediatrics. 2013; 45(1):16-21. DOI: 10.1055/s-0033-1349226. View

Zhang Y, Zheng Y, Zhu J, Zhang J, Zheng Z . Effects of antiepileptic drugs on bone mineral density and bone metabolism in children: a meta-analysis. J Zhejiang Univ Sci B. 2015; 16(7):611-21. PMC: 4506952. DOI: 10.1631/jzus.B1500021. View

Nicolaidou P, Georgouli H, Kotsalis H, Matsinos Y, Papadopoulou A, Fretzayas A . Effects of anticonvulsant therapy on vitamin D status in children: prospective monitoring study. J Child Neurol. 2006; 21(3):205-9. DOI: 10.2310/7010.2006.00050. View

Marcus J, Pettifor J . Folate and mineral metabolism in poorly nourished epileptic children. Arch Neurol. 1980; 37(12):772-4. DOI: 10.1001/archneur.1980.00500610052008. View

Farghaly W, Abd Elhamed M, Hassan E, Soliman W, Yhia M, Hamdy N . Prevalence of childhood and adolescence epilepsy in Upper Egypt (desert areas). Egypt J Neurol Psychiatr Neurosurg. 2018; 54(1):34. PMC: 6245138. DOI: 10.1186/s41983-018-0032-0. View

10.

Fong C, Kong A, Poh B, Mohamed A, Khoo T, Ng R . Vitamin D deficiency and its risk factors in Malaysian children with epilepsy. Epilepsia. 2016; 57(8):1271-9. DOI: 10.1111/epi.13443. View

11.

Dura-Trave T, Gallinas-Victoriano F, Malumbres-Chacon M, Moreno-Gonzalez P, Aguilera-Albesa S, Yoldi-Petri M . Vitamin D deficiency in children with epilepsy taking valproate and levetiracetam as monotherapy. Epilepsy Res. 2017; 139:80-84. DOI: 10.1016/j.eplepsyres.2017.11.013. View

12.

Viraraghavan V, Seth A, Aneja S, Singh R, Dhanwal D . Effect of high dose vitamin d supplementation on vitamin d nutrition status of pre-pubertal children on anti-epileptic drugs - A randomized controlled trial. Clin Nutr ESPEN. 2019; 29:36-40. DOI: 10.1016/j.clnesp.2018.11.007. View

13.

Ramelli V, Ramelli G, Lava S, Siegenthaler G, Cantu M, Bianchetti M . Vitamin D status among children and adolescents on anticonvulsant drugs in southern Switzerland. Swiss Med Wkly. 2014; 144:w13996. DOI: 10.4414/smw.2014.13996. View

14.

Farhat G, Yamout B, Mikati M, Demirjian S, Sawaya R, El-Hajj Fuleihan G . Effect of antiepileptic drugs on bone density in ambulatory patients. Neurology. 2002; 58(9):1348-53. DOI: 10.1212/wnl.58.9.1348. View

15.

McCabe P . New anti-epileptic drugs for the 21st century. Expert Opin Pharmacother. 2001; 1(4):633-74. DOI: 10.1517/14656566.1.4.633. View

16.

Chaudhuri J, Mridula K, Rathnakishore C, Balaraju B, Bandaru V . Association of 25-Hydroxyvitamin D Deficiency in Pediatric Epileptic Patients. Iran J Child Neurol. 2017; 11(2):48-56. PMC: 5493830. View

17.

Fong C, Riney C . Vitamin D deficiency among children with epilepsy in South Queensland. J Child Neurol. 2013; 29(3):368-73. DOI: 10.1177/0883073812472256. View

18.

Paticheep S, Chotipanich C, Khusiwilai K, Wichaporn A, Khongsaengdao S . Antiepileptic Drugs and Bone Health in Thai Children with Epilepsy. J Med Assoc Thai. 2015; 98(6):535-41. View

19.

Yaghini O, Tonekaboni S, Amir Shahkarami S, Ahmad Abadi F, Shariat F, Abdollah Gorji F . Bone mineral density in ambulatory children with epilepsy. Indian J Pediatr. 2014; 82(3):225-9. DOI: 10.1007/s12098-014-1518-0. View

20.

Samaniego E, Sheth R . Bone consequences of epilepsy and antiepileptic medications. Semin Pediatr Neurol. 2007; 14(4):196-200. DOI: 10.1016/j.spen.2007.08.006. View