Osteoporosis in liver cirrhosis

Abstract

Background: Osteoporosis is still an underestimated complication of liver cirrhosis (LC). AIM. To study the prevalence of osteoporosis and osteopenia in patients with LC and to identify the principal risk factors associated.

Material and methods: The prevalence of osteoporosis and osteopenia was studied in 150 patients with alcoholic or viral LC who were admitted to the Institute of Gastroenterology and Hepatology, Iasi in 2003. Osteoporosis was diagnosed by measuring their bone density using dual energy X-ray absorptiometry (DXA). Patients with liver disease due to multiple aetiologies or with other liver conditions (primary biliary cirrhosis, autoimmune or metabolic causes, etc.) as well post menopausal women were excluded from the study. The variables taken into consideration were: gender, nutritional status (body mass index - BMI), etiology of liver disease, presence of cholestasis, severity and duration of disease.

Results: Fifty-seven patients with LC (38%) were found to have osteoporosis or osteopenia. There was a statistically significant correlation between the presence of bone changes and a BMI of <20 kg/m2, cholestasis, Child class C and long duration of disease (>10 years). During the study period, despite the relatively high rate of bone metabolism abnormalities, there were no pathological fractures in the patients group.

Conclusions: Osteoporosis has a raised prevalence in patients with LC. It is important to be diagnosed and treated early, especially when risk factors such as malnutrition, cholestasis and a severe liver disease are present for a long period of time.