MON-P063: Association between Presarcopenia, Sarcopenia and Bone Mineral Density in Patients with Chronic Hepatitis C

Bering, Tatiana; Diniz, K.G.D.; Coelho, M.P.P.; Vieira, Diva Aliete dos Santos; Soares, Maria Marta Sarquis; Kakehasi, Adriana Maria; Correia, Maria Isabel Toulson Davisson; Teixeira, Rosângela; Queiroz, Dulciene M.; Rocha, G.A.; Silva, L.D.

doi:10.1016/s0261-5614(17)31020-8

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“…These findings are inconsistent with previous largescale community-based studies in non-cirrhotics [39] as well as a study indicating correlation between sarcopenia and low BMD in patients with chronic hepatitis, the majority without established cirrhosis [40]. The reasons for these discrepancies are unclear but may be related to differences in the study populations as well as in assessment of the muscle component between the current study (performed by means of MAMC measurement) and previous reports (which included computed tomography [39] or DXA muscle scanning [40] as well as evaluation of muscle strength [39,40] to define sarcopenia). Future studies evaluating the potential relationship of sarcopenia with osteoporosis should probably include assessments of muscle mass, strength, and performance [39].…”

Section: Discussioncontrasting

confidence: 99%

Osteoporosis in cirrhotics before and after liver transplantation: relation with malnutrition and inflammatory status

Huldén

Castedal

Karlsson

et al. 2020

Scandinavian Journal of Gastroenterology

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Background: Liver cirrhosis is associated with osteoporosis and liver transplantation (LT) with increased bone loss. This study aimed to in LT candidates investigate the potential relation between bone mineral density (BMD) and BMD loss in those who undergo LT, with malnutrition, systemic inflammation, and hormonal status. Methods: We included 102 consecutively recruited cirrhotic LT candidates between May 2004 and April 2007. BMD was assessed by means of dual energy X-ray absorptiometry (DXA). Malnutrition was defined by means of anthropometry and assessment of recent weight loss. In 75/102 patients, serumthyroid stimulating hormone (TSH), free triiodthyronine (T3) and free thyroxine (T4) and growth hormone (GH), cortisol, free testosterone, dehydroepiandrosterone sulfate, estradiol, interleukin-6, and tumor necrosis factor (TNF)-a was assessed. Overall 57/102 patients received a LT and 47/102 were followed for one year post-LT. At follow-up, nutritional status and BMD were assessed in all patients (n ¼ 47) while 34/47 had available blood samples for analysis. Results: Forty (40%) LT-candidates had osteopenia or osteoporosis and 34 (38%) were malnourished. Malnutrition was associated with osteopenia/osteoporosis (odds ratio: 3.5, 95% CI 1.4, 9.9). Hip BMD Zscore decreased À0.25 (95% CI À0.41, À0.09) from baseline to one year post-LT. High baseline TNF-a correlated with a more marked decline in BMD (Partial correlation (r) ¼ À0.47, p < .05) as did high baseline cortisol levels (r ¼ À0.49, p < .05). Conclusion: Malnutrition in liver cirrhosis seems to be associated with osteopenia/osteoporosis, and systemic inflammation (higher TNF-a) and systemic stress (higher cortisol) to bone loss in patients who undergo LT.

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