Journal
HEPATOLOGY INTERNATIONAL
Volume 10, Issue 3, Pages 470-477Publisher
SPRINGER
DOI: 10.1007/s12072-015-9672-7
Keywords
Hepatitis B virus; Bone mineral density; Hepatic osteodystrophy; Viral hepatitis; Osteoporosis
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Hepatic osteodystrophy has been reported in patients with various chronic liver diseases, including liver cirrhosis. However, it has not been well investigated in patients with hepatitis B virus infection. The aim of this study was to investigate the association between hepatitis B surface antigen (HBsAg) seropositivity and bone mineral density (BMD) in a population representative of normal Koreans. Subjects with both HBsAg and BMD levels examined during the 2008-2010 Korea National Health and Nutrition Examination Surveys were included. HBsAg-seropositive (+) subjects were compared with those who were HBsAg-seronegative (-). BMD was measured at the lumbar spine and femur by dual-energy X-ray absorptiometry. Multivariable logistic regression was performed for BMD . In total, 11,306 participants were included in this study, among which 423 (3.7 %) were HBsAg(+): 153 premenopausal female (3.4 %), 83 postmenopausal female (3.5 %), and 187 male (4.2 %). Multivariable logistic regression analysis adjusted for age and body mass index showed that HBsAg(+) male had significantly lower BMD of the femoral neck than HBsAg(-) male (0.810 +/- A 0.009 vs. 0.827 +/- A 0.002 g/cm(2), p = 0.035). Further adjustment for waist circumference, smoking, drinking, exercise, income, occupation, and vitamin D levels showed that HBsAg(+) male had significantly lower BMD of the femur neck (0.810 +/- A 0.010 vs. 0.831 +/- A 0.002 g/cm(2), p = 0.032) and lumbar spine (0.953 +/- A 0.011 vs. 0.974 +/- A 0.003 g/cm(2), p = 0.049) than HBsAg(-) male. HBsAg seropositivity was significantly associated with lower BMD in male. Future long-term prospective studies investigating bone turnover markers and hormones are needed to better understand the pathophysiology and clinical significance of chronic hepatitis B virus-related hepatic osteodystrophy.
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