Osteoporosis in chronic liver disease: a case–control study

Abstract

Osteoporosis has become an increasingly recognized complication among patients with chronic liver disease (CLD). The aim of the present study was to assess the prevalence and risk factors of osteoporosis in patients with CLD (primary biliary cirrhosis and chronic viral hepatitis B or C patients) in comparison with a group of age- and sex-matched controls. Sixty-four patients with CLD (mean age 51.66 +/- 11.54 years), 48 females and 16 males were included. Age- and sex-matched individuals from the general population served as controls. Osteoporosis was evaluated by dual energy X-ray absorptiometry (bone mineral density below -2.5 T score) at the lumbar spine (LS) and total hip (TH). Vertebral fractures were established by densitometric morphometry (vertebral fracture assessment). Bone turnover was assessed by intact parathyroid hormone, osteocalcin and C-telopeptides of type I collagen in the serum. Prevalence of osteoporosis in either the LS or the TH was 45.3%, twice as high as in the controls (19.6%) (RR 2.31, 95% CI 1.42-3.75, P < 0.001). Age, menopausal status, cirrhosis and advanced histological stage are not determinant factors for developing osteoporosis in patients with CLD. However, female sex, cholestasis, lower weight and height but not body mass index seem to play predominant role. Three (5.3%) patients had dorsal and LS fractures. It was concluded that osteoporosis is effectively a complication of CLD. Cholestasis in addition to female sex and lower weight and height are risk factors of osteoporosis in CLD.

Immune complexes regulate bone metabolism through FcRγ signalling

“…IC-induced osteoclastogenesis may contribute to both osteoporosis and the local bone erosion that occurs in various autoimmune diseases including RA and SLE, chronic inflammatory diseases 39,40 , multiple myeloma 41 and monoclonal gammopathy of undetermined significance 42 , which are all characterized by a high IgG production. The direct effect of the ICs on osteoclasts may also explain, at least in part, the bone-protective effect of the B-cell-depleting anti-CD20 antibody rituximab in RA patients 43,44 .…”

Low bone mineral density in chronic Hepatitis B virus infection: A case-control study

“…It is a metabolic bone disease secondary to increased resorption and reduced formation of bone 2. Osteoporosis is the well-known major complication in this chronic hepatitis 3. The prevalence of osteoporosis in CLD varies widely, ranges from 20 to 50% depending on patient selection and diagnostic criteria 4.…”

Epidemiology and awareness of osteoporosis: a viewpoint from the Middle East and North Africa

“…Moreover, the severity of tumor significantly correlated with the hip and spine DXA. Prevalence of OP in chronic liver disease patients was 45.3%, and 18.2% in HCV (hepatitis C virus) patients [112,113]. Thermal burn victims have higher prevalence of OP [114,115].…”