This study aimed to evaluate the impact of prolonged sodium valproate use on bone mineral density (BMD) and Vitamin D levels in pediatric epilepsy patients. In a cross-sectional study conducted at the Epilepsy Clinic of Niloufer Hospital, Hyderabad, India, 50 pediatric patients (aged 4–10 years) were recruited. The cohort comprised 30 epilepsy patients on sodium valproate treatment (cases) and 20 healthy siblings without epilepsy or valproate use (controls). BMD was assessed using dual-energy X-ray absorptiometry to measure height-adjusted total body less head Z-scores (TBLH Z-scores), and serum 25-hydroxyvitamin D levels were measured. Statistical analysis included independent samples t-tests, Mann-Whitney U tests, and Pearson correlation, with a preliminary power analysis ensuring adequate sample size. Cases exhibited significantly lower BMD TBLH Z-scores (Mean = -1.543) compared to controls (Mean = 0.515, p <.001) and reduced Vitamin D levels (Mean = 9.17 for cases vs. 27.80 for controls, p <.001). A negative correlation was observed between the duration of sodium valproate use and both BMD Z-scores (r = -0.626, p <.001) and Vitamin D levels (r = -0.707, p <.001). The findings suggest a significant negative impact of prolonged sodium valproate use on both bone density and Vitamin D levels in pediatric patients. These results underscore the importance of monitoring and managing bone health in children receiving long-term sodium valproate therapy.

中文翻译：

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丙戊酸钠治疗持续时间对骨密度和维生素 D 水平的影响

本研究旨在评估长期使用丙戊酸钠对小儿癫痫患者骨矿物质密度 (BMD) 和维生素 D 水平的影响。印度海得拉巴 Niloufer 医院癫痫诊所开展的一项横断面研究招募了 50 名儿科患者（4-10 岁）。该队列由 30 名接受丙戊酸钠治疗的癫痫患者（病例）和 20 名未患癫痫或未使用丙戊酸钠的健康兄弟姐妹（对照）组成。使用双能 X 射线吸收测定法测量高度调整的全身减头 Z 分数 (TBLH Z 分数) 来评估 BMD，并测量血清 25-羟基维生素 D 水平。统计分析包括独立样本 t 检验、Mann-Whitney U 检验和 Pearson 相关性，并进行初步功效分析以确保足够的样本量。与对照组相比，病例的 BMD TBLH Z 分数（平均值 = -1.543）显着降低（平均值 = 0.515，p <.001），并且维生素 D 水平降低（病例平均值 = 9.17，对照组平均值 = 27.80，p <.001） 。观察到丙戊酸钠使用持续时间与 BMD Z 分数（r = -0.626，p <.001）和维生素 D 水平（r = -0.707，p <.001）之间存在负相关。研究结果表明，长期使用丙戊酸钠会对儿科患者的骨密度和维生素 D 水平产生显着的负面影响。这些结果强调了监测和管理接受长期丙戊酸钠治疗的儿童骨骼健康的重要性。