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Antiepileptic Medications Increase Osteoporosis Risk in Male Fabry Patients: Bone Mineral Density in an Australian Cohort.
[fabry disease]
Background
:
Fabry
disease
(
FD
)
is
an
inherited
X-
linked
lysosomal
storage
disease
with
widespread
clinical
manifestations
.
Small
prospective
studies
have
shown
increased
osteopenia
and
osteoporosis
in
male
FD
patients
.
Limited
information
however
exists
about
bone
metabolism
and
osteoporosis
risk
factors
within
this
group
.
We
reviewed
osteoporosis
risk
factors
within
our
cohort
.
Methods
:
A
retrospective
analysis
of
bone
mineral
density
(
BMD
)
results
and
fracture
incidence
in
44
patients
(
22
males
and
22
females
)
was
undertaken
.
Dual
X-
ray
absorptiometry
scans
were
performed
at
the
lumbar
spine
,
hip
and
femoral
neck
.
The
impact
of
risk
factors
including
renal
function
,
antiepileptic
drug
(
AED
)
,
analgesia
and
vitamin
D
levels
were
assessed
.
Results
:
Male
FD
patients
had
low
T
scores
at
all
sites
(
spine
-
1
.
2
±
1
.
06
,
hip
-
1
.
6
±
0
.
9
,
femoral
neck
-
2
.
23
±
1
.
01
)
.
Female
T
scores
showed
more
typical
distribution
(
spine
-
0
.
07
±
1
.
47
,
hip
0
.
02
±
1
.
14
,
femoral
neck
-
0
.
49
±
1
.
31
)
.
A
higher
incidence
of
osteopenia
and
/
or
osteoporosis
occurred
in
males
versus
females
(
spine
46
.
9
%
versus
31
.
8
%
,
hip
75
.
5
%
versus
18
.
2
%
and
femoral
neck
86
.
4
%
versus
45
.
5
%
)
.
Multiple
regression
analysis
showed
a
50
.
8
%
(
p
<
0
.
001
)
reduction
in
femoral
neck
BMD
with
AED
usage
,
after
adjustment
for
age
,
gender
and
renal
function
.
Non-traumatic
fractures
occurred
in
27
.
3
%
males
over
205
patient-
years
versus
4
.
6
%
in
females
over
149
patient-
years
,
p
=
0
.
095
.
Conclusions
:
Low
bone
density
was
highly
prevalent
in
male
patients
with
increased
incidence
of
non-traumatic
fractures
.
AED
usage
significantly
reduces
BMD
.
Treatment
to
prevent
BMD
deterioration
willdepend
on
determining
the
bone
turnover
status
.
Diseases
Validation
Diseases presenting
"female t scores"
symptom
fabry disease
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