Hepatic osteodistrophy in patient of liver cirrhosis

Background and aim: Hepatic osteodistrophy is an important problem that is seen inpatient of liver cirrhosis. We intented to search the relation of osteoporosis between 55cirrhosis patients and 30 control group by comparing, in this study .Material and methods: The bone mineral dansity of patient and the group of control ismeasured by DEXA method. The women in this study are premenoposal. It is measured thatdeoxipyridinolin, pyridinolin at urine Ca++ as markers of bones ruin; IGF- 1, osteocalcine, ALPas markers of bone anabolism; moreover IL-1, IL-6, TNF-, D3 vitamin, direct biluribin,albumin, cortisol, PTH are measured. It is used that Chi-square and independent T test in bothtwo groups when compared. Pearson correlation method is used for analysis of the study.Results: At cirrhosis group lumbal total T-score (in respectively -1,6±1,2; -0,25±1,3g/cm² ; p<0,001), lumbal total Z-score (in respectively -1,2±1,23; -0.6±1,3 g/cm²; p<0,001), totalfemur T-score (in respectively 0,05±1; -0,6±0,9g/cm²; p=0,003) and total femur Z-score (inrespectively, -0,08±1,5; 0,7±0,9 g/cm²; p=0,003), this values are low according to the controlgroup. The level of blood ALP (in respectively 109,2±57; 62,6±32,5 U/L; p<0,001), IL-6 level (inrespectively 27,9±51,6; 3,3±3,1 pg/ml; p= 0,01), TNF- level (in respectively 42,6±33,2;25,3±12,3 pg/ml; p =0,007) , direct bilurubin (in respectively 0,9±0,7; 0,3±0,2; p<0,001) it ishigh according to control group, as statistical. IGF-1 level (in respectively 47,7±26,2;143,4±53,2 ng/ml; p<0,001), osteocalcine (in respectively 1,05±2,5; 7,0±13 ng/ml; p=0,002), 24hours at urine Ca (in respectively 169,6±227,2; 287±168,6 mgr/dl; p=0,003) It is low asmeaningful according to control group . Urinary deoxipyridinolin/creat. (in respectively 9,4±9,9;8,1±5,3 pmol / ?mol; p=0,51), urinary pyridinolin/creat (in respectively 51,3±66,6; 29±25,8pmol/ ?mol; p=0,08), blood IL-1 level 3,4±8,8; 1,6±3,5pg/ml; p=0,29), Vit D3 level (inrespectively 18,6±13,3; 18,4±8,9?g/l , p= 0,95), cortisol level (in respectively 11,1±4,8; 12,6±4,3?g/dl; p=0,15), PTH level (in respectively 42,7±38; 34,8±10,9 ?g/dl; p=0,27) was not differentaccording to control group.Conclusion:1- The mineral density is decreasing in patient with liver cirrhosis. The reason isdecreasing of bone anabolism.IX2- The responsible factors are decreasing of IGF-1 and osteocalcine, and increasing of IL-6, TNFinpatients with liver cirrhosis. Also, the high biluribinemia has inhibitor effect forbone anabolism in patients with liver cirrhosis.3- Hepatic osteodistrophy is an important complication of liver cirrhosis. For this reason,the patients of liver cirrhosis should be checked and followed-up for hepatic osteodistrophy.