Effect of long-term carbamazepine therapy on bone metabolism in women with epilepsy

Objective. To evaluate the impact of long-term carbamazepine monotherapy on bone metabolism and bone mineral density in women with epilepsy. Material and methods. The study included 60 women with epilepsy alongside a control group of 55 healthy women. Serum levels of interleukin-7 (IL-7), estradiol, transforming growth factor-beta4 (TGF-β4), alkaline phosphatase, calcium, and phosphorus were measured in all participants. Bone mineral density and structure were assessed using dual-energy X-ray absorptiometry (DEXA). Results. The findings from the early osteoporosis diagnosis examination revealed that the levels of estradiol, IL-7, and TGF-β4 were outside the normal range. In contrast, calcium, phosphorus, and alkaline phosphatase levels remained within reference ranges. Bone mineral density and T-score measurements obtained via DEXA in the lumbar spine, right radius, and right hip exhibited positive correlations with serum levels of estradiol, IL-7, and TGF-β4. Conversely, significant negative correlations were observed with serum calcium, phosphorus, and alkaline phosphatase. Conclusions. Prolonged carbamazepine treatment considerably increases the risk of osteoporosis in women by disrupting hormonal and cytokine regulation, underscoring the critical need to monitor biomarkers such as estradiol, TGF-β4, and IL-7 to facilitate early diagnosis and prevention of osteoporosis.