BACKGROUND Previous studies have reported that long-term use of valproic acid can cause changes in bone metabolism in children. We conducted this meta-analysis to determine the effects of valproic acid on bone metabolism and bone mineral density (BMD) in children with epilepsy. METHODS Studies were searched from the databases of PubMed, Embase, Ovid, Cochrance Library, Springer Link and Web of Science. The effects of valproic acid on bone metabolism indicators and BMD were assessed through calculating the standardized mean difference (SMD) with 95% confidence interval (CI). RESULTS Fourteen studies with 987 individuals were included in this analysis. The long-term use of valproic acid did not affect the levels of serum calcium (p = 0.99), phosphorus (p = 0.28), ALP (p = 0.76), PTH (p = 0.36) and osteocalcin (p = 0.72), but it led to a decrease in 25-OH-VitD (p = 0.01) and BMD (p = 0.002 for the vertebra; p = 0.004 for the femur) in treating children with epilepsy. CONCLUSION Long-term use of valproic acid in treating children with epilepsy can lead to a reduction in 25-OH-VitD and BMD. Measurements of 25-OH-VitD and BMD should be performed regularly in children taking the drug to detect early osteopenia caused by the drug.

中文翻译：

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丙戊酸对癫痫儿童骨骼代谢的影响：基于 14 项研究的系统评估和荟萃分析。


背景技术既往研究报道，长期服用丙戊酸会引起儿童骨代谢的变化。我们进行了这项荟萃分析，以确定丙戊酸对癫痫儿童骨代谢和骨矿物质密度 (BMD) 的影响。方法 从 PubMed、Embase、Ovid、Cochrance Library、Springer Link 和 Web of Science 的数据库中检索研究。通过计算95%置信区间（CI）的标准化均差（SMD）来评估丙戊酸对骨代谢指标和BMD的影响。结果 本分析纳入了 14 项涉及 987 名个体的研究。长期使用丙戊酸不影响血清钙（p = 0.99）、磷（p = 0.28）、ALP（p = 0.76）、PTH（p = 0.36）和骨钙素（p = 0.72）的水平。但在治疗癫痫儿童时，它导致 25-OH-VitD（p = 0.01）和 BMD（椎骨 p = 0.002；股骨 p = 0.004）下降。结论长期使用丙戊酸治疗儿童癫痫可导致25-OH-VitD和BMD降低。服用该药物的儿童应定期进行 25-OH-VitD 和 BMD 测量，以发现该药物引起的早期骨质减少。