Osteoporosis in cirrhotic patients and relevant factors

Introduction and Aim: Cirrhosis is a disease which can manifest with various complications as it progresses. Due to increase in transplantation and supportive medicine and therefore in survival, metabolic bone disease gains significance among the complications. Osteoporosis is known to be more frequent in cirrhotic patients and scanning is recommended in this manner. This study aims to evaluate and demonstrate clinical and laboratory factors which might have an influence on osteoporosis development. Patients and Method: 25 male and 18 female cirrhotic patients were enrolled in this study. Demographic and clinical features were questioned and noted, laboratory and imaging values were recorded retrospectively. Patients were classified as normal, osteopenic, osteoporotic in accordance with their bone mineral density measurements via DXA. Concurrently patients' sexual functions were assessed using international index of erectile function and female sexual function index. Results: Age (p=0.028), total testosterone (p=0.015), free androgen index (p=0.019), estradiol (p=0.004), follicle stimulating hormone (p=0.019) and serum calcium levels corrected with albumin (p=0.028) were statistically distinctive between osteoporotic and non-osteoporotic subjects. The subjects were then classified in three different groups regarding their bone mineral densities as normal, osteopenic and osteoporotic and estradiol (p=0.015), follicle stimulating hormone (p=0.023) and serum magnesium (p=0.014) levels were statistically different between groups. Multivariate regression analyses showed serum calcium (B=3.68, OR:39.65) and estradiol (B=-0.09, OR:0.92) levels were independent determinants of osteoporosis development (Model R2=0.34). Conclusion: Among cirrhotics, serum calcium levels corrected for albumin and serum estradiol levels were determined as independent predictors of osteoporosis development.