Ayu Mawari, 051615153035 (2018) ANALISIS KADAR SERUM P1NP TERHADAP REGENERASI TULANG PADA PASIEN EPILEPSI DENGAN TERAPI TUNGGAL VALPROAT ATAU FENITOIN JANGKA PANJANG (Penelitian dilakukan di Poli Saraf Instalasi Rawat Jalan RSU Haji Surabaya). Skripsi thesis, Universitas Airlangga.

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Abstract

BACKGROUND – According to WHO 2018, epilepsy affects ~50 million people worldwide. Mortality rates of epilepsy in the developing countries are reported to be higher than under developed countries. Patients with epilepsy have a risk of fractures about 2-6 times greater than general population. Valproate and phenytoin reported to be associated with decreased bone mineral density (BMD), changes in bone turnover and increased risk of fractures. OBJECTIVE – The aim of this prospective study was to analyze serum P1NP levels as marker of bone formation in epilepsy patients who received long-term valproate or phenytoin therapy. METHOD – The serum P1NP levels were measured on routine patient visit to ambulatory care of neurology department. Sample was collected by consecutive sampling in cross sectional study from August – September 2018. Protocol of this study had been reviewed by Ethical Committee Haji General Hospital Surabaya. P1NP were measured with ELISA and statistical analysis was analyzed by Independent T Test and Pearson correlation. RESULT – A total of 22 patients participated in this study. The serum P1NP levels were obtained in the valproate group (mean 182.63 ± 18.24ng/ml) lower than phenytoin group (mean 451 ± 105,1ng/ml) in long term use with normal reference in healthy subject (20- 480ng/ml). No correlation was found between serum P1NP levels with age, gender, height, body mass index (BMI), and duration of AED. CONCLUSION – Patients with a history of prolonged use of valproate or phenytoin suggested for BMD testing and recommended for supplementation of calcium and vitamin D due to risk of fractures.

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