Proximal Hip Geometry, Trabecular Bone Score, Bone Mineral Density and Bone Mineral Parameters in Patients With Cryptogenic and Hepatitis B Related Cirrhosis- A Study From the Indian Subcontinent

Thakur, Purnima; Cherian, Kripa Elizabeth; Kapoor, Nitin; Rebekah, Grace; Goel, Ashish; Zachariah, Uday; Eapen, CE; Nicolaï, Thomas; Paul, Thomas

doi:10.1016/j.jocd.2021.03.001

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…Patients with cryptogenic cirrhosis had significantly low TBS. 60 Low TBS values have been associated with a worse bone structure and a higher risk of fracture. 61 Moreover, HCV patients had lower TBS values even after adjustment of possible confounders.…”

Section: Diagnosis Dual-energy X-ray Absorptiometry and Trabecular Bo...mentioning

confidence: 99%

Impact of Liver Cirrhosis on Bone Metabolism

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Sobh

Abdelsalam

et al. 2022

Digestive Disease Interventions

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Bone loss is an early and major problem in cirrhotic patients. The majority of cirrhotic patients demonstrate evidence of hepatic osteodystrophy (HOD). This includes decreased bone volume, turnover abnormalities, and rarely mineralization defects. Moreover, the degree of bone disease usually correlates with the severity of liver dysfunction. The mechanism of HOD is multifactorial. Vitamin D insufficiency/deficiency, secondary hyperparathyroidism, hypogonadism, inhibitors of bone formation, and mediators/promoters of bone resorption are frequent findings and essential coplayers in HOD. Early and proper identification of HOD is challenging. DXA is the most widely used tool; however, it has fundamental limitations. Bone turnover biomarkers are used to understand the mechanism of bone loss. Bone biopsy with histomorphometry is the gold standard to evaluate bone structure. The evidence for the effectiveness of nonpharmacological and pharmacological management of HOD is limited. Adequate nutrition, weight-bearing exercise, smoking cessation, and limitation of alcohol consumption improve bone health and quality of life. The use of antiresorptive therapies prevents bone loss particularly in patients with high bone turnover. However, osteoanabolics are essential in patients with low bone turnover. Herein, we are discussing the magnitude of the problem, pathogenesis, diagnosis of HOD, and various interventions to improve bone health in cirrhotic patients.

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Section: Diagnosis Dual-energy X-ray Absorptiometry and Trabecular Bo...mentioning

confidence: 99%

Impact of Liver Cirrhosis on Bone Metabolism

Abdalbary

Sobh

Abdelsalam

et al. 2022

Digestive Disease Interventions

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“…The HSA program may find additional benefit in certain disease cohorts where mere assessment of BMD may not convey ample information about all aspects of bone health. [ 16 18 ]…”

Section: A Dditional U Sesmentioning

confidence: 99%

Dual-energy X-ray absorptiometry scanning in practice, technical aspects, and precision testing

et al. 2021

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The last three decades have witnessed considerable progress in the field of bone densitometry. Osteoporosis may be diagnosed in postmenopausal women and in men aged 50 and older if the bone mineral density (BMD) T-scores of the lumbar spine, total hip, or femoral neck are −2.5 or less. For reporting T-scores, the Hologic dual-energy X-ray absorptiometry (DXA) scanner uses the Caucasian (nonrace adjusted) female normative database for women and men of all ethnic groups although reference database used does have an impact on the categorization of BMD and must be chosen judiciously considering the regional and ethnic characteristics of the population. The quality control for DXA systems should be periodically done in accordance with manufacturer guidelines for DXA. Beyond conventional BMD assessment, DXA may also be utilized to assess the trabecular bone score, hip structural analysis, vertebral fractures, and body composition.

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“…In addition to BMD, microarchitectural alterations can significantly contribute to the fracture risk. The trabecular bone score (TBS) is a densitometric tool that evaluates pixel gray-level variations in lumbar spine DXA images, providing an indirect measure of the bone microarchitecture [ 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. There is a paucity of literature on bone microarchitecture in women with morbid obesity and no available data from the South Asian region.…”

Section: Introductionmentioning

confidence: 99%

Trabecular Bone Score and Bone Mineral Density in Postmenopausal Women with Morbid Obesity—A Clinical Paradox

et al. 2021

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Obesity has long been considered to have a protective effect on bone, but specific complications in those with morbid obesity are known to have a detrimental impact on bone architecture. We aimed to study the bone microarchitecture (TBS—trabecular bone score) and bone mineral density (BMD) in postmenopausal women with morbid obesity compared to obese and non-obese age-matched women. Eighty-five consecutive postmenopausal women with morbid obesity (body mass index (BMI) ≥ 35 kg/m2) were enrolled and compared to age-matched obese (n = 80) and non-obese postmenopausal controls (n = 85). The BMD and TBS were assessed in all subjects using a Hologic-QDR 4500-W Discovery-A DXA scanner. The mean BMD (gm/cm2) at the femoral neck in women with morbid obesity was found to be significantly lower as compared to the age-matched postmenopausal obese controls (0.723 versus 0.762, p-value = 0.002). The BMD at the lumbar spine and hip showed similar trends but were not statistically significant. The bone microarchitecture was found to be significantly lower in those with morbid obesity (1.205) as compared to the other two groups (obesity 1.244; non-obese 1.228) (p < 0.013). Though obesity was associated with a better bone density and bone microarchitecture in postmenopausal women, a paradoxical lower value was seen in those with morbid obesity.

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Proximal Hip Geometry, Trabecular Bone Score, Bone Mineral Density and Bone Mineral Parameters in Patients With Cryptogenic and Hepatitis B Related Cirrhosis- A Study From the Indian Subcontinent

Cited by 5 publications

References 25 publications

Impact of Liver Cirrhosis on Bone Metabolism

Impact of Liver Cirrhosis on Bone Metabolism

Dual-energy X-ray absorptiometry scanning in practice, technical aspects, and precision testing

Trabecular Bone Score and Bone Mineral Density in Postmenopausal Women with Morbid Obesity—A Clinical Paradox

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