Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Exp Med. Sep 20, 2025; 15(3): 104799
Published online Sep 20, 2025. doi: 10.5493/wjem.v15.i3.104799
Anti-epileptic medication induced disturbed calcium-vitamin D metabolism: A behavioral analysis using association rule mining technique
Pradeep K Dabla, Kamal Upreti, Divakar Singh, Anju Singh, Vinod Puri, Adina E Stanciu, Nafija Serdarevic, Damien Gruson
Pradeep K Dabla, Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, Associated Maulana Azad Medical College, New Delhi 110002, Delhi, India
Kamal Upreti, Department of Computer Science, CHRIST (Deemed to be University), Ghaziabad 201003, India
Divakar Singh, Barkatullah University Institute of Technology, Barkatullah University, Bhopal 462026, India
Anju Singh, Department of Computer Science and Engineering, Lakshmi Narain College of Technology Kalchuri Nagar, Bhopal 462022, India
Vinod Puri, Department of Neurology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, Associated Maulana Azad Medical College, New Delhi 110002, Delhi, India
Adina E Stanciu, Department of Carcinogenesis and Molecular Biology, Institute of Oncology Bucharest, Bucharest 022328, Romania
Adina E Stanciu, Faculty of Biology, University of Bucharest, Bucharest 050095, Romania
Nafija Serdarevic, Institute for Clinical Chemistry and Biochemistry, University of Sarajevo Clinics Center, Sarajevo 71000, Bosnia and Herzegovina
Damien Gruson, Department of Clinical Biochemistry, Department of Laboratory Medicine, Cliniques Universitaires Saint-Luc and Université, Brussels 1200, Belgium
Co-corresponding authors: Pradeep K Dabla and Kamal Upreti.
Author contributions: Dabla PK planned and oversaw the study, supplied testing facilities, helped with data processing and analysis, and revised and finalized the report; Upreti K, Singh D, and Singh A helped draft the text and conducted data analysis; Gruson D, Stanciu AE, and Serdarevic N helped to finalize or revise it; Puri V provided locations where patients were allowed to register; Dabla PK and Upreti K contributed equally to this article, they are the co-corresponding authors of this manuscript; All authors thoroughly reviewed and endorsed the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Maulana Azad Medical College and Affiliated Hospitals, approval IEC/MAMC/82/10/2020. No. 225.
Informed consent statement: Written informed consent was taken from all participants for the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: All data is available with the corresponding author, Dr Pradeep Kumar Dabla.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pradeep K Dabla, MD, Professor, Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, Associated Maulana Azad Medical College, 1 Jawaharlal Nehru Marg, 64 Khamba, Raj Ghat, New Delhi 110002, Delhi, India. pradeep_dabla@yahoo.com
Received: January 2, 2025
Revised: March 11, 2025
Accepted: April 7, 2025
Published online: September 20, 2025
Processing time: 222 Days and 19.9 Hours
Abstract
BACKGROUND

There is a lack of study on vitamin D and calcium levels in epileptic patients receiving therapy, despite the growing recognition of the importance of bone health in individuals with epilepsy. Associations one statistical method for finding correlations between variables in big datasets is called association rule mining (ARM). This technique finds patterns of common items or events in the data set, including associations. Through the analysis of patient data, including demographics, genetic information, and reactions with previous treatments, ARM can identify harmful drug reactions, possible novel combinations of medicines, and trends which connect particular individual features to treatment outcomes.

AIM

To investigate the evidence on the effects of anti-epileptic drugs (AEDs) on calcium metabolism and supplementing with vitamin D to help lower the likelihood of bone-related issues using ARM technique.

METHODS

ARM technique was used to analyze patients’ behavior on calcium metabolism, vitamin D and anti-epileptic medicines. Epileptic sufferers of both sexes who attended neurological outpatient and in patient department clinics were recruited for the study. There were three patient groups: Group 1 received one AED, group 2 received two AEDs, and group 3 received more than two AEDs. The researchers analyzed the alkaline phosphatase, ionized calcium, total calcium, phosphorus, vitamin D levels, or parathyroid hormone values.

RESULTS

A total of 150 patients, aged 12 years to 60 years, were studied, with 50 in each group (1, 2, and 3). 60% were men, this gender imbalance may affect the study’s findings, as women have different bone metabolism dynamics influenced by hormonal variations, including menopause. The results may not fully capture the distinct effects of AEDs on female patients. A greater equal distribution of women should be the goal of future studies in order to offer a complete comprehension of the metabolic alterations brought on by AEDs. 86 patients had generalized epilepsy, 64 partial. 42% of patients had AEDs for > 5 years. Polytherapy reduced calcium and vitamin D levels compared to mono and dual therapy. Polytherapy elevated alkaline phosphatase and phosphorus levels.

CONCLUSION

ARM revealed the possible effects of variables like age, gender, and polytherapy on parathyroid hormone levels in individuals taking antiepileptic medication.

Keywords: Anti-epileptic drugs; HotSpot; Epilepsy; Association rule mining; Transaction and metabolism

Core Tip: Research on vitamin D and calcium levels in epileptic patients receiving therapy is conspicuously lacking, despite the growing recognition of the importance of bone health in individuals with epilepsy. The purpose of this study is to close this gap by analyzing calcium intake patterns in epileptic patients on single, dual, or activity-based anti-epileptic drug regimens. The study’s objective is to use association rule mining technique to identify patterns and relationships that could inform more individualized and efficient care plans for people with epilepsy, ultimately improving their overall bone health outcomes.