Effects of cirrhosis on bone mineral density and bone metabolism.

objectiveThe present study was undertaken to examine the correlation between the severity of liver disease and the presence and severity of bone disease in patients with hepatic cirrhosis. MATERIALS AND

methodsBetween January 2005 and February 2006, 40 patients with cirrhosis and 22 healthy controls were enrolled in a cross-sectional study. All subjects underwent standard laboratory testing and bone densitometric studies of the lumbar spine and femoral neck using dual X-ray absorptiometry (DEXA).

resultsCirrhotic patients had lower serum follicle-stimulating hormone (FSH) levels than controls. Male patients had lower serum free testosterone (fT) levels than male controls. 25-hydroxyvitamin D (25-OHD3) levels were significantly higher in the controls as compared to patients with cirrhosis. In the cirrhotic group, 25-OHD3 concentrations did not differ significantly between patients with Child B and C class cirrhosis. As compared to the control group, cirrhotic patients had significantly elevated levels of urinary deoxypyridinoline (DPD). The cirrhotic patients also had a significantly lower mean spinal (SD) bone mineral density (BMD) than the control group. BMD of the lumbar spine (LS) was noted to be significantly lower in the Child C group than in the Child B group. In the cirrhotic patients, there was a positive correlation between the BMD T score of the femoral neck (FN) and albumin levels whereas there was a negative correlation between BMD T scores of the FN and age, bilirubin and prothrombin time (PT).

conclusionOsteopenia and osteoporosis are highly prevalent in individuals with liver cirrhosis. Cirrhotic patients should undergo routine bone densitometric assessment and, if necessary, be treated for osteoporosis.