|
Proposed mechanisms contributing to AED induced bone disease. |
| • Vitamin D Inactivation |
| • Hepatic enzyme induction |
| • PXR activation |
| • Altered calcium metabolism (DPH) |
| • ↓ Intestinal absorption |
| • ↓ vitamin D mediated absorption |
| • ↓ intestinal cation transport |
| • ↑ PTH |
| • Vitamin D insufficiency |
| • ↓ cellular response to PTH |
| • Vitamin K deficiency |
| • ↓ Calcitonin |
| • Osteoblast Inhibition |
| • Altered sex-steroid & SHBG metabolism |
| • Possible modulation of Aromatase activity |
|
Abbreviations: PXR: Pregnane X receptor, DPH: phentyoin, PTH: parathyroid hormone, SHBG: sex hormone binding globulin |
Valsamis et al. Nutrition & Metabolism 2006 3:36 doi:10.1186/1743-7075-3-36 |