The prevalans of osteoporosis in chronic liver diseases

Introduction and AimThe aim of this study was to determine the osteoporosis at different sites in cirrhotic patients and relation of osteoporosis with duration and severity of disease.Material and MethodsWe studied 44 cirrhotic patient, (26 males, 18 females, mean age: 48,18±12,265) diagnosed both clinically and histopathologically and 27 healthy control subjects, (12 males, 15 females, mean age 32,89±12,007). 19 patients were in Child A, 12 were in Child B and 13 were in Child C stage. Bone mineral density (BMD) was measured by dual x-ray absorbtiometry in the lumbar spine, forearm and femoral neck. Bone metabolism markers and hormone profiles were measured.FindingsOsteoporosis at lumbar spine was found in 33,3% of female and 42,3% of male patients while 16,7% of females and 26,9% of males had osteoporosis at femur. According to forearm BMD measurements, 33,3% of women and 57,7% of men had osteoporosis. There were no significant differences between Child-Pugh class A, B and C in BMD T and Z scores (p>0.05).)There was no statistical significance amongparameters of phosfor, TSH, prolactin,cortisol and GH levels (p>0.05). There was statistically significant result 25 OH D vitamini, serum kalsiyum, ve parathyroid hormone levels between patients group and control group (p<0.05).No association was found between duration of disease and child staging with BMD values. Although association was found between child staging and forearm BMD values. Serum levels of 25 OH D vitamin and serum calcium were significantly lower in patients with cirrhosis than in controls (p=0.006, p=0.0001, respectively). In patients, parathyroid hormone were significantly higher than in control subjects, (p=0.002).ConclusionOur findings show that cirrhosis is a major cause of osteoporosis in patients. Cirrhotic patients have sedantery lives due to their diseases. Osteoporotic fractures increase the duration and grade of immobilisation and diminish quality of patients lives. For this reason cirrhotic patients should be evaluated for osteoporosis thus the number of subsequent fractures may be decreased by early diagnose and intervention.Kew WordsCirrhosis, osteoporosis, DEXA, bone mineral density