Journal
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY
Volume 14, Issue 1, Pages 43-48Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/00042737-200201000-00008
Keywords
bone disease; hyperbilirubinaemia; liver disease; vitamin D
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Objective Patients with chronic liver disease (CLD) have an Increased prevalence of osteoporosis. The aim of this study was to evaluate prospectively the rate of bone loss and potential predictors of increased bone loss in a cohort of patients with CLD. Design Bone mineral density (BMD) was measured at baseline and at follow-up by dual-energy X-ray absorptiometry at the lumbar spine and the femoral neck. Results Forty-three patients (31 female, 12 male) were available for a second measurement of BMD, with a median of 25 months (range 18-41) between the measurements. Mean annual bone loss at the lumbar spine and the femoral neck, respectively, was 0.6 +/- 2.0% and 1.5 +/- 2.4% in females and 0.8 +/- 1.9% and 2.9 +/- 2.0% in males. The BMD Z score decreased significantly over time at the femoral neck (P = 0.005 and P = 0.02 for females and males, respectively). Bone loss was Increased significantly at the lumbar spine in patients classified as Child - Pugh B + C compared with those classified as Child - Pugh A (P = 0.04). Serum levels of bilirubin correlated independently and positively, and 25-hydroxy vitamin D-3 levels negatively, with bone loss at the femoral neck. Conclusions Patients with CLD have increased bone loss at the femoral neck. Advanced liver disease is associated with increased bone loss, and hyperbilirubinaemia and low levels of vitamin D-3 are predictors of increased bone loss. Eur J Gastroenterol Hepatol 14:43-48 (C) 2002 Lippincott Williams Wilkins.
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