Osteoporosis en la cirrosis hepática

Guañabens, Núria; Parés, Albert

doi:10.1016/j.gastrohep.2012.01.017

Cited by 18 publications

(4 citation statements)

References 57 publications

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“…Previous reports suggested that patients with cirrhosis have a higher prevalence of osteoporosis. [20] Low BMD occurs in at least 20% of patients with chronic liver disease. [21] The prevalence of osteoporosis in patients with chronic liver disease is 12%5 to 5%.…”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with hepatic osteopathy in HBV related cirrhosis measured by liver stiffness

Zhang¹,

Gong

et al. 2019

Medicine

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To investigate the differences in bone mineral density between patients with liver cirrhosis and healthy control, and to analyze the risk factors of hepatic osteoporosis in patients with HBV related liver cirrhosis. A total of 189 patients with liver cirrhosis and 207 health controls were enrolled. The bone mineral density of lumbar spine and femoral neck was examined by dual energy X-ray absorptiometry. −2.0

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Section: Discussionmentioning

confidence: 99%

Risk factors associated with hepatic osteopathy in HBV related cirrhosis measured by liver stiffness

Zhang¹,

Gong

et al. 2019

Medicine

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“…The main mechanism by which osteoporosis develops in liver disease is defects in bone formation, through the harmful effects of substances such as bilirubin and bile acids, or through the toxic effects of alcohol or iron on osteoblasts. For osteoporosis prevention and treatment, good nutrition as well as calcium and vitamin D supplements can be provided (Guañabens and Parés, 2012).…”

Section: Gm Liver and Serum Calciummentioning

confidence: 99%

Gut microbiota and calcium balance

Wang

Zhang

et al. 2022

Front. Microbiol.

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Microorganisms living on the surface and inside the human body play an important role in the physiological activities of the human body. The largest microecosystem in the human body is the gut microbiome. Calcium disorders are found in many diseases. For example, patients with chronic renal insufficiency present with secondary hyperparathyroidism, which is caused by a calcium imbalance in the body. In addition, calcium dysregulation may affect lipid metabolism in the liver through the calmodulator pathway, leading to cirrhosis, etc. Currently, a considerable number of probiotics have been proven to enhance the body’s absorption of calcium. This paper reviews the effects of intestinal flora and related factors such as short-chain fatty acids, estrogen, immune factors and vitamin D on calcium balance.

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“…Unabhängig von der Ätiologie und Schwere der Zirrhose sind Prävalenz und Frakturrisiko im Vergleich zur nicht-zirrhotischen Bevölkerung erhöht [106,107]. Die Prävalenz der Osteoporose bei Zirrhosepatienten beträgt 12 -70 % (Übersichten bei [105,108,109]). Bei chronischen cholestatischen Lebererkran-kungen (insbesondere bei der PBC) ist die Prävalenz besonders hoch und häufig besteht hier bereits vor Eintreten einer Zirrhose eine verminderte Knochenmineraldichte (KMD).…”

Section: Diagnose Und Sekundärprophylaxe Bei Osteoporoseunclassified

Versorgung bei kompensierter Leberzirrhose 2018 – Evidenzbasierte prophylaktische Maßnahmen

et al. 2018

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In 2015, more than 13 000 people died due to the consequences of liver cirrhosis in Germany. Frequently, relevant liver fibrosis is diagnosed by non-invasive methods (e. g., ultrasound-based measurement of liver stiffness) already in the compensated stage. Following diagnosis of liver fibrosis, a thorough investigation of the underlying chronic liver disease and effective treatment are important to prevent progression to decompensated cirrhosis. Since morbidity and mortality dramatically increase in the decompensated stage (patients may present with jaundice, ascites, hepatic encephalopathy, gastrointestinal bleeding) with an upsurge in 1-year-mortality from 1 - 3.4 % to 20 - 57 %, prophylactic measures to prevent decompensation are indicated. Based on a risk stratification, these measures include propranolol or carvedilol as non-selective betablockers, as well as endoscopic band ligations as primary prophylaxis to prevent variceal bleeding. Because of the high risk for malignant transformation (2 - 8 % per year depending on the underlying etiology), surveillance by liver ultrasound every six months is essential to detect liver cancer in an early stage and to facilitate curative therapy. Currently under debate is the administration of antibiotics to prevent bacterial infections, which commonly trigger acute decompensation. To this regard, studies are not convincing and the risk to induce drug resistance has to be observed. However, health care providers should check the vaccination status and recommend missing vaccinations. The management of compensated liver cirrhosis also includes counseling and potentially also a drug therapy to prevent osteoporosis and muscle wasting. In this review, we will discuss specific prophylactic measures in the management of compensated liver cirrhosis based on the pathophysiological background and central clinical studies. If a patient decompensates despite these prophylactic measures (approximately 15 % of patients with liver cirrhosis per year), liver transplantation has to be discussed as definitive therapy (especially in patients with MELD > 15).

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Osteoporosis en la cirrosis hepática

Cited by 18 publications

References 57 publications

Risk factors associated with hepatic osteopathy in HBV related cirrhosis measured by liver stiffness

Risk factors associated with hepatic osteopathy in HBV related cirrhosis measured by liver stiffness

Gut microbiota and calcium balance

Versorgung bei kompensierter Leberzirrhose 2018 – Evidenzbasierte prophylaktische Maßnahmen

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