Abstract：
OBJECTIVE: To investigate vitamin D levels and factors associated with seizure control in adult patients with epilepsy (APE).
METHODS: Cross-sectional study with APE in routine outpatient follow-up at a neurology clinic. Clinical variables, antiseizure medications (ASM) and vitamin D were investigated. Data were analyzed using the Chi2 or Fisher\'s exact tests, Mann-Whitney, Spearman\'s correlation coefficient, ROC curve and univariate and multiple logistic regression analysis.
RESULTS: Mean age was 46.5±15.1 years and disease duration was 27.5±17.0 years; 52.7% (n=49) of patients used one ASM and 47.3% (n=44) used≥2 ASM. There was a significant difference in the level of vitamin D according to the number of ASM and it was higher in patients who used a single ASM (26.02±10.22 versus 22.50±8.69; P=0.048). In the logistic regression, when vitamin D level was set at 20ng/mL, the chance of seizure control for patients using a single ASM was 6.99 times greater than for those using≥2 ASM. When vitamin D level was set at 40ng/mL, the number of ASM did not modify seizure control. There was no correlation between vitamin D and disease duration, patient age and age at the time of the first seizure. In the logistic regression, it was observed that satisfactory levels of vitamin D did not modify potential seizure control.
CONCLUSIONS: Thirty-three percent (33%) of patients presented with vitamin D deficiency (values below 20ng/mL) and 80% had vitamin D levels below what is recommended (30ng/mL). The use of ASM, when associated with different levels of vitamin D, modified the probability of seizure control in APE. Vitamin D levels and intrinsic epilepsy factors are associated with failure to effectively control seizures.
METHODS: Cross-sectional study with APE in routine outpatient follow-up at a neurology clinic. Clinical variables, antiseizure medications (ASM) and vitamin D were investigated. Data were analyzed using the Chi2 or Fisher\'s exact tests, Mann-Whitney, Spearman\'s correlation coefficient, ROC curve and univariate and multiple logistic regression analysis.
RESULTS: Mean age was 46.5±15.1 years and disease duration was 27.5±17.0 years; 52.7% (n=49) of patients used one ASM and 47.3% (n=44) used≥2 ASM. There was a significant difference in the level of vitamin D according to the number of ASM and it was higher in patients who used a single ASM (26.02±10.22 versus 22.50±8.69; P=0.048). In the logistic regression, when vitamin D level was set at 20ng/mL, the chance of seizure control for patients using a single ASM was 6.99 times greater than for those using≥2 ASM. When vitamin D level was set at 40ng/mL, the number of ASM did not modify seizure control. There was no correlation between vitamin D and disease duration, patient age and age at the time of the first seizure. In the logistic regression, it was observed that satisfactory levels of vitamin D did not modify potential seizure control.
CONCLUSIONS: Thirty-three percent (33%) of patients presented with vitamin D deficiency (values below 20ng/mL) and 80% had vitamin D levels below what is recommended (30ng/mL). The use of ASM, when associated with different levels of vitamin D, modified the probability of seizure control in APE. Vitamin D levels and intrinsic epilepsy factors are associated with failure to effectively control seizures.
摘要：
目的：探讨成人癫痫患者维生素D水平及其与癫痫发作控制相关的因素。
方法：在神经科门诊进行常规门诊随访的APE横断面研究。临床变量，研究了抗癫痫药物（ASM）和维生素D。使用Chi2或Fisher精确检验分析数据，Mann-Whitney,斯皮尔曼相关系数，ROC曲线及单因素和多因素logistic回归分析。
结果：平均年龄为46.5±15.1岁，病程为27.5±17.0岁；52.7%(n=49)的患者使用1例ASM，47.3%(n=44)的患者使用≥2例ASM。根据ASM的数量，维生素D的水平存在显着差异，并且使用单一ASM的患者的维生素D水平更高（26.02±10.22对22.50±8.69；P=0.048）。在逻辑回归中，当维生素D水平设定为20ng/mL时，使用单一ASM的患者控制癫痫发作的机会是使用≥2个ASM的患者的6.99倍.当维生素D水平设定为40ng/mL时，ASM的数量并未改变癫痫发作控制.维生素D与病程无相关性,患者年龄和第一次发作时的年龄。在逻辑回归中，据观察,令人满意的维生素D水平并未改变潜在的癫痫发作控制.
结论：33%的患者出现维生素D缺乏（低于20ng/mL），80%的患者维生素D水平低于推荐水平（30ng/mL）。使用ASM，当与不同水平的维生素D相关时，改变了APE中癫痫发作控制的可能性。维生素D水平和内在癫痫因素与未能有效控制癫痫发作有关。
方法：在神经科门诊进行常规门诊随访的APE横断面研究。临床变量，研究了抗癫痫药物（ASM）和维生素D。使用Chi2或Fisher精确检验分析数据，Mann-Whitney,斯皮尔曼相关系数，ROC曲线及单因素和多因素logistic回归分析。
结果：平均年龄为46.5±15.1岁，病程为27.5±17.0岁；52.7%(n=49)的患者使用1例ASM，47.3%(n=44)的患者使用≥2例ASM。根据ASM的数量，维生素D的水平存在显着差异，并且使用单一ASM的患者的维生素D水平更高（26.02±10.22对22.50±8.69；P=0.048）。在逻辑回归中，当维生素D水平设定为20ng/mL时，使用单一ASM的患者控制癫痫发作的机会是使用≥2个ASM的患者的6.99倍.当维生素D水平设定为40ng/mL时，ASM的数量并未改变癫痫发作控制.维生素D与病程无相关性,患者年龄和第一次发作时的年龄。在逻辑回归中，据观察,令人满意的维生素D水平并未改变潜在的癫痫发作控制.
结论：33%的患者出现维生素D缺乏（低于20ng/mL），80%的患者维生素D水平低于推荐水平（30ng/mL）。使用ASM，当与不同水平的维生素D相关时，改变了APE中癫痫发作控制的可能性。维生素D水平和内在癫痫因素与未能有效控制癫痫发作有关。
