Bone changes in alcoholic liver cirrhosis

Jorge-Hernández, J.A.; González-Reimers, C.E.; Torres, Armando; Santolaria-Fernández, Francisco; González-Garcı́a, Cándido; Batista-López, J.N.; Pestana-Pestana, M; Hernández-Nieto, L

doi:10.1007/bf01535783

Cited by 48 publications

(8 citation statements)

References 30 publications

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“…Studies on hepatic osteodystrophy in humans have indicated that the most striking change in the profile of biochemical markers of bone remodeling is the reduction of osteocalcin, i.e., reduction in the activity of bone formation (26,27). These data are supported by results obtained in histomorphometric evaluation in experimental models of CCLD (5) as well as in humans (28,29). …”

Section: Discussionsupporting

confidence: 81%

Pamidronate for the treatment of osteoporosis secondary to chronic cholestatic liver disease in Wistar rats

Pereira

Mattar

Facincani

et al. 2012

Braz J Med Biol Res

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Osteoporosis is a major complication of chronic cholestatic liver disease (CCLD). We evaluated the efficacy of using disodium pamidronate (1.0 mg/kg body weight) for the prevention (Pr) or treatment (Tr) of cholestasis-induced osteoporosis in male Wistar rats: sham-operated (Sham = 12); bile duct-ligated (Bi = 15); bile duct-ligated animals previously treated with pamidronate before and 1 month after surgery (Pr = 9); bile duct-ligated animals treated with pamidronate 1 month after surgery (Tr = 9). Rats were sacrificed 8 weeks after surgery. Immunohistochemical expression of IGF-I and GH receptor was determined in the proximal growth plate cartilage of the left tibia. Histomorphometric analysis was performed in the right tibia and the right femur was used for biomechanical analysis. Bone material volume over tissue volume (BV/TV) was significantly affected by CCLD (Sham = 18.1 ± 3.2 vs Bi = 10.6 ± 2.2%) and pamidronate successfully increased bone volume. However, pamidronate administered in a preventive regimen presented no additional benefit on bone volume compared to secondary treatment (BV/TV: Pr = 39.4 ± 12.0; Tr = 41.2 ± 12.7%). Moreover, the force on the momentum of fracture was significantly reduced in Pr rats (Sham = 116.6 ± 23.0; Bi = 94.6 ± 33.8; Pr = 82.9 ± 22.8; Tr = 92.5 ± 29.5 N; P < 0.05, Sham vs Pr). Thus, CCLD had a significant impact on bone histomorphometric parameters and pamidronate was highly effective in increasing bone mass in CCLD; however, preventive therapy with pamidronate has no advantage regarding bone fragility.

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Section: Discussionsupporting

confidence: 81%

Pamidronate for the treatment of osteoporosis secondary to chronic cholestatic liver disease in Wistar rats

Pereira

Mattar

Facincani

et al. 2012

Braz J Med Biol Res

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“…Additionally, no detailed parameters of cortical microstructure or bone geometry have so far been evaluated in patients with cirrhosis. Dynamic histomorphometry in cirrhosis has suggested reduced formation, increased resorption, and normal mineralization [ 6 ] with no signs of osteomalacia [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…These findings indicate a loss of structural integrity already at the early stages. Similarly, histomorphometric studies have reported no differences between different Child-Pugh stages [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

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Bone microarchitecture and bone turnover in hepatic cirrhosis

et al. 2019

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Summary Liver cirrhosis leads to bone loss. To date, information on bone quality (three-dimensional microarchitecture) and, thus, bone strength is scarce. We observed decreased bone quality at both assessed sites, independent of disease severity. Therefore, all patients should undergo early-stage screening for osteoporosis. Introduction Recent studies found low bone mineral density in cirrhosis, but data on bone microstructure are scarce. This study assessed weight-bearing and non-weight-bearing bones in patients with cirrhosis and healthy controls. The primary objective was to evaluate trabecular and cortical microarchitecture. Methods This was a single-center study in patients with recently diagnosed hepatic cirrhosis. Thirty-two patients and 32 controls participated in this study. After determining the type of cirrhosis, the parameters of bone microarchitecture were assessed by high-resolution peripheral quantitative computed tomography. Results Both cortical and trabecular microarchitectures showed significant alterations. At the radius, trabecular bone volume fraction was 17% lower (corrected p = 0.028), and, at the tibia, differences were slightly more pronounced. Trabecular bone volume fraction was 19% lower ( p = 0.024), cortical bone mineral density 7% ( p = 0.007), and cortical thickness 28% ( p = 0.001), while cortical porosity was 32% higher ( p = 0.023), compared to controls. Areal bone mineral density was lower (lumbar spine − 13%, total hip − 11%, total body − 9%, radius − 17%, and calcaneus − 26%). There was no correlation between disease severity and microarchitecture. Areal bone mineral density (aBMD) measured by dual-energy X-ray absorptiometry (DXA) correlated well with parameters of cortical and trabecular microarchitecture. Conclusions Hepatic cirrhosis deteriorates both trabecular and cortical microarchitecture, regardless of disease severity. Areal bone mineral density is diminished at all sites as a sign of generalized affection. In patients with hepatic cirrhosis, regardless of its origin or disease severity, aBMD measurements are an appropriate tool for osteologic screening.

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“…In cases of bone loss, bone biopsies from cirrhotic patients have findings that are quite similar to those seen in elderly people [37]. The exception is alcoholic liver cirrhosis, in which impaired osteoblastic activity leads to increased resorption surfaces, lowering the trabecular bone volume [13, 94]. …”

Section: Diagnosis and Screeningmentioning

confidence: 99%

Diagnosis and Management of Cirrhosis-Related Osteoporosis

Santos

Romeiro

2016

BioMed Research International

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Management of cirrhosis complications has greatly improved, increasing survival and quality of life of the patients. Despite that, some of these complications are still overlooked and scarcely treated, particularly those that are not related to the liver. This is the case of osteoporosis, the only cirrhosis complication that is not solved after liver transplantation, because bone loss often increases after immunosuppressant therapy. In this review, the definitions of bone conditions in cirrhotic patients are analyzed, focusing on the more common ones and on those that have the largest impact on this population. Risk factors, physiopathology, diagnosis, screening strategies, and treatment of osteoporosis in cirrhotic patients are discussed, presenting the more striking data on this issue. Therapies used for particular conditions, such as primary biliary cirrhosis and liver transplantation, are also presented.

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Bone changes in alcoholic liver cirrhosis

Cited by 48 publications

References 30 publications

Pamidronate for the treatment of osteoporosis secondary to chronic cholestatic liver disease in Wistar rats

Pamidronate for the treatment of osteoporosis secondary to chronic cholestatic liver disease in Wistar rats

Bone microarchitecture and bone turnover in hepatic cirrhosis

Diagnosis and Management of Cirrhosis-Related Osteoporosis

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