Bone mineral density among cirrhotic patients awaiting liver transplantation

Abstract

Osteoporosis is an important and common complication in patients with chronic liver disease. The goal of this study was to determine the bone mineral density (BMD) in different subgroups among pretransplant cirrhotic patients. BMD of the lumbar vertebrae (L) and femoral neck (F) were obtained in 104 consecutive cirrhotic patients. Descriptive and inferential statistics were used to compare the BMD among various groups. The mean BMD in males (n = 54) and females (n = 50) at L were 1.28 +/- 0.25 g/cm(2) and 1.13 +/- 0.20 g/cm(2), respectively (P =.001); at F they were 1.03 +/- 0.14 and 0.91 +/- 0.17, respectively (P <.0001). Among males, BMD at L in Child-Turcotte-Pugh class B and C were 1.40 +/- 0.21 and 1.13 +/- 0.20, respectively (P =.001); at F they were 1.11 +/- 0.10 and 0.93 +/- 0.13, respectively (P <.0001). Among females, BMD at L in Child-Turcotte-Pugh class B and C were 1.27 +/- 0.18 and 1.05 +/- 0.16, respectively (P =.0003); at F they were 1.02 +/- 0.16 and 0.83 +/- 0.12, respectively (P =.001). The BMD in premenopausal females (n = 15) and postmenopausal females (n = 35) at L were 1.20 +/- 0.19 and 1.11 +/- 0.20, respectively (P =.15); at F they were 0.97 +/- 0.17 and 0.88 +/- 0.16, respectively (P =.12). The BMD in postmenopausal females on hormone replacement therapy (n = 19) and on no hormone replacement therapy (n = 16) at L were 1.07 +/- 0.17 and 1.14 +/- 0.23, respectively (P =.29); at F they were 0.85 +/- 0.15 and 0.91 +/- 0.18, respectively (P =.33). The BMD values between etiologic groups were not significantly different. The overall prevalence of osteopenia and osteoporosis were 34.6% and 11.5%, respectively, being significantly higher in females than in males. In conclusion, significant difference in BMD values exists between males and females, as well as between Child-Turcotte-Pugh class B and C patients with cirrhosis. In addition, there is no significant influence of menopausal status, hormone replacement therapy, and etiology of cirrhosis on BMD.