Is liver transplantation associated with decreased bone mass in climacteric women?

Baccaro, Luiz Francisco; Boin, I.F.S.F.; Leal, Aline Garcia; Ramos, Celso Darío; Pinto‐Neto, Aarão Mendes

doi:10.1590/s0100-72032012000700008

Cited by 3 publications

(5 citation statements)

References 30 publications

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“…Abnormal BMD was present in 25% of the SG, higher in women (40%), and similar to the prevalence observed in climacteric women after liver transplantation (14.6% of osteoporosis and 35.4% of low bone mass). 18 Various mechanisms explain changes in bone metabolism after allogeneic HSCT such as the decreased bone formation related to the pre-HSCT conditioning regimen, as well as medications such as cyclosporine and glicocorticoides, 19 besides the severity of the underlying disease, that can compromise bone mineral density and muscle strength. 20 , 21 Nevertheless, in this study neither the underlying disease nor the use of glucocorticoids or any variable related to the HSCT was correlated to the BMD.…”

Section: Discussionmentioning

confidence: 99%

Pre-sarcopenia and bone mineral density in adults submitted to hematopoietic stem cell transplantation

Pereira

Amaral

Funke

et al. 2017

Revista Brasileira de Hematologia e Hemoterapia

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BackgroundThe aim of this study was to evaluate the prevalence of pre-sarcopenia and bone mineral density after hematopoietic stem cell transplantation.MethodsThe study group consisted of over 18-year-old patients who had been submitted to allogeneic transplantation at least one year previously. Patients and healthy controls were matched by sex, ethnic background, age, and body mass index. Body composition and bone mineral density were measured by dual-energy X-ray absorptiometry. A 24-h food recall and food frequency survey were performed. The biochemical evaluation included calcium, parathormone and vitamin D. Eighty-seven patients (52 men; age: 37.2 ± 12.7 years; body mass index: 25 ± 4.5 kg/m2) were compared to 68 controls [31 men; age 35.4 ± 15.5 years (p = 0.467); body mass index 25.05 ± 3.7 kg/m2 (p = 0.927)].ResultsThere was no significant difference in the dietary intake between patients and controls. The mean levels of vitamin D were 23.5 ± 10.3 ng/mL; 29 patients (41.0%) had insufficient and 26 (37.14%) deficient levels. A higher prevalence of reduced bone mineral density was observed in 24 patients (25%) compared to 12 controls (19.1% – p < 0.001). Pre-sarcopenia was diagnosed in 14 (14.4%) patients and none of the controls (p = 0.05). There was a higher prevalence of pre-sarcopenia (66%) in patients with grades III and IV compared to those with grades 0-II graft-versus-host disease (10.9%) (p = 0.004).Conclusionpatients submitted to transplantation had a higher prevalence of pre-sarcopenia and greater changes in bone mineral density compared to controls; the severity of graft-versus-host disease had an impact on the prevalence of pre-sarcopenia.

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Section: Discussionmentioning

confidence: 99%

Pre-sarcopenia and bone mineral density in adults submitted to hematopoietic stem cell transplantation

Pereira

Amaral

Funke

et al. 2017

Revista Brasileira de Hematologia e Hemoterapia

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“…Liver-transplanted women in the perimenopausal period are especially vulnerable to bone density loss due to immunosuppressive treatment, often comprising high doses of glucocorticoids, used directly after transplantation, and cyclosporine, which also has a big influence on bone mass loss. Due to the fact that it is hard to determine the effect of various factors that may have an influence on osteoporosis, such as age, menopause, liver diseases, or liver transplantation, individual therapeutic management should be applied and hormonal therapy implementation should be considered [ 18 , 19 ].…”

Section: Osteoporosismentioning

confidence: 99%

Menopause in women with chronic immunosuppressive treatment – how to help those patients

Cyganek

Pietrzak

Wielgoś

et al. 2016

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Women after organ transplantation with chronic immunosuppressive therapy or after bone marrow transplantation without such therapy are a growing group of patients. Although their problems in the peri-and postmenopausal period are the same as in healthy women, due to the primary disease and treatment applied they represent a huge challenge from the point of view of their hormonal treatment of menopause. Transplanted women have no particular contraindications for hormonal therapy use. General contraindications, however, such as arterial hypertension, thrombosis in medical history, diabetes, endometriosis, myomas, or active neoplastic disease, have a higher incidence in this group of patients than in healthy women, which significantly influences the possibility of using hormonal therapy. On the other hand, taking into consideration the predisposition for premature menopause in this group, in combination with chronic immunosuppression, it predisposes these patients for higher cardiovascular disease incidence and bone density loss, so hormonal therapy would be highly advisable. Therapy management in transplanted patients requires special care and close monitoring of the transplanted organ. Saving lives with organ transplantation is one of the greatest achievements of contemporary medicine. For long-term improvement of their quality of life, emphasis should be put on regular diagnostic examinations, early detection of abnormalities, and introduction of effective treatment.

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“…Среди причин нормализации костного обмена рассматриваются также восстановление уровней половых гормонов [15,27]. Однако данные о связи между повышением МПК и изменением маркеров гормональной регуляции после ОТП, особенно при использовании схем иммуносупрессивной терапии на основе такролимуса, малочисленны и противо-речивы [20,5].…”

Section: вестник трансплантологии и искусственных органовunclassified

“…У женщин в пост-менопаузе увеличение МПК, выраженное, однако, в меньшей степени, чем у женщин в пременопаузе, отмечалось на фоне сниженного уровня эндогенно-го эстрадиола. Аналогичные данные представлены в работе Baccaro et al [5] при сравнении изменения МПК после ОТП у женщин в возрасте менее 35 лет и старшей возрастной группы. Более того, через 6 лет после ОТП авторы не отметили достовер-ных различий МПК у женщин старшей возрастной группы от женщин контрольной группы, сопоста-вимой по возрасту, но не имеющих заболеваний пе-чени [5].…”

Section: обсуждение результатовunclassified

“…Аналогичные данные представлены в работе Baccaro et al [5] при сравнении изменения МПК после ОТП у женщин в возрасте менее 35 лет и старшей возрастной группы. Более того, через 6 лет после ОТП авторы не отметили достовер-ных различий МПК у женщин старшей возрастной группы от женщин контрольной группы, сопоста-вимой по возрасту, но не имеющих заболеваний пе-чени [5]. Таким образом, уменьшение костных по-терь, наблюдаемое в отдаленные сроки после ОТП, ассоциируется c появлением закономерных взаи-мосвязей между БКЛ и КТРКФ-5б, а также между маркерами резорбции и маркерами гормональной регуляции костного метаболизма ПТГ и витами-на D 3 .…”

Section: обсуждение результатовunclassified

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Biochemical Markers of Bone Resorption and Hormonal Regulation of Bone Metabolism Following Liver Transplantation

Бузулина¹,

Пронченко²,

Ермакова³

et al. 2014

Russian Journal of Transplantology and Artificial Organs

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ФГБУ «Федеральный научный центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава России, г. Москва Цель исследования: сравнительная оценка изменений двух маркеров резорбции и оценка состояния гор-мональной регуляции костной резорбции у реципиентов в различные сроки после трансплантации печени. Методы и результаты. В различные сроки после ортотопической трансплантации печени (ОТП) выпол-нено исследование минеральной плотности кости (МПК) в области поясничных позвонков (L2-L4) и шей-ки бедра, гормонов (ПТГ, витамина D 3 , эстрадиола, тестостерона), проведен сравнительный анализ двух маркеров резорбции БКЛ и КТРКФ-5б. Через 1 месяц после ОТП отмечено снижение МПК, уровня вита-мина D 3 , эстрадиола у женщин, тестостерона у мужчин, повышение маркеров резорбции кости. Через 1 и 2 года после ОТП минеральная плотность L2-L4 увеличивалась на фоне возрастания уровня ПТГ, половых гормонов и снижения БКЛ, в то время как уровни витамина D 3 и КТРКФ-5б оставались стабильными. Заключение. Установлено, что КТРКФ-5б в ранние сроки после ОТП является более специфичным маркером резорбции кости. Остеопороз в поздние сроки ассоциировался с повышенными значениями КТРКФ-5б и у женщин с пониженным уровнем эстрадиола.Ключевые слова: ортотопическая трансплантация печени, остеопороз, маркеры костной резорбции. BIOCHEMICAL MARKERS OF BONE RESORPTION AND HORMONAL REGULATION OF BONE METABOLISM FOLLOWING LIVER TRANSPLANTATION Buzulina V.P., Pronchenko I.A., Ermakova I.P., Shmerko N.P., Kornilov M.N., Yaroshenko E.B., Koliashvili T.K. Academician V.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs, MoscowAim. Comparative evaluation of two biochemical markers of bone resorption and hormonal regulation of bone metabolism in liver recipients. Methods and results. Bоne densitometry of L2-L4 and neck of femur, serum level of some hormones (PTH, vitamin D 3 , estradiol, testosterone) regulating osteoclastogenesis as well as comparative analyses of two bone resorption markers β-crosslaps and tartrate-resistant acid phosphatase type 5b (TRAP-5b) were fulfi lled in patients after orthotopic liver transplantation (OLT). In 1 month after OLT bone density reduction of L2-L4 and neck of femur; decrease of vitamin D 3 , estradiol in women, testosterone in men and increase levels of bone resorption markers were observed. In 1 and 2 years after OLT the rise of bone density, increased levels of PTH, estradiol, testosterone and decreased β-crosslaps levels were revealed, while vitamin D 3 and TRAP-5b levels remained stable. Conclusion. TRAP-5b was found to be a more speciffi c marker of bone resorption, independent from collagen metabolism in liver. Osteoporosis defi ned in long-term period after OLT was associated with higher TRAP-5b and revialed in women with low estradiol level.

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Is liver transplantation associated with decreased bone mass in climacteric women?

Abstract: Liver transplantation was not associated with decreased bone mass in this group of climacteric women.

Cited by 3 publications

References 30 publications

Pre-sarcopenia and bone mineral density in adults submitted to hematopoietic stem cell transplantation

Pre-sarcopenia and bone mineral density in adults submitted to hematopoietic stem cell transplantation

Menopause in women with chronic immunosuppressive treatment – how to help those patients

Biochemical Markers of Bone Resorption and Hormonal Regulation of Bone Metabolism Following Liver Transplantation

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