THE EFFECTS OF SODIUM VALPROATE MONOTHERAPY ON THE BODY'S VITAMIN K STATUS IN CHILDREN

Abstract

Aim: Our study aimed to investigate Vitamin K status in children using sodium valproate (VPA), a subject not formerly reported in the literature and the effects of VPA use for a period of one year on Vitamin K status. Material and Method: The study conducted prospectively at the Department of Neurology, Faculty of Medicine, Cumhuriyet University over a period of one year included 25 children (14 male, 11 female) aged between 4 to 17 who received VPA for the first time and 25 children (12 male, 13 female) in a similar age range as the control group. Patients were divided into two stages as pre-puberty and puberty according to Tanner's criteria, and the carboxylated (cOC) and undercarboxylated (ucOC) fractions of osteocalcin were measured using the ELISA (Enzyme Linked Immunoassay) method both pre-therapy and one year post-therapy. The ratio of undercarboxylated osteocalcin to carboxylated osteocalcin was described as UCR, and Delta-UCR the difference between start and end of UCRs. Result: Although carboxylated osteocalcin demonstrated a minimal increase following VPA treatment in the pre-puberty group, it was observed to decrease in the puberty group. We noted that, although higher in the pre-puberty group, undercarboxylated osteocalcin was observed to decrease compared with their start values in both groups. UCR values decreased in the pre-puberty group and increased in the puberty group. We noted a negative Delta-UCR value in the puberty group. Discussion: We noted that the use of VPA for our pre-puberty group of patients did not affect the body's Vitamin K status to the extent that it would have negative results. The results of our study demonstrate that the body's Vitamin K status tended to decline in our puberty group patients (increase in UCR), that there was a weakened capacity to meet the need (decrease in cOC), and that the bone metabolism was negatively affected (negative Delta-C value).