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Bone mineral density loss in patients with cirrhosis.
Saudi J Gastroenterol. 2018 Nov-Dec; 24(6):342-347.SJ

Abstract

Background/Aims

Evidence of increased risk of osteoporosis and osteopenia in chronic liver disease and cirrhosis is inconsistent. This study aims to investigate this relationship and to identify the predictors of increased loss of bone mineral density in Saudi patients.

Patients and Methods

One hundred and sixty-four patients and controls who are age and gender matched, were included in this study with 1:1 ratio. Patients' included in this study were adults with confirmed liver cirrhosis. Bone mineral densitometry (BMD) at both lumbar spine (LS) and femoral neck (FN) were collected for both groups. Univariate and multivariate regression analyses were performed to identify predictors of BMD loss.

Results

Results showed that cirrhotic patients are at higher risk of developing osteoporosis or osteopenia at LS (OR 2.23, 95% CI [1.19-4.19], P = 0.01) but not at FN, when compared to control sample. Patients with cirrhosis were found to have lower vitamin D and PTH levels (P = 0.0005) and (P = 0.006), respectively. Of the possible predictors tested (gender, age, body mass index [BMI], phosphorus, calcium, parathyroid hormone (PTH), vitamin D, and Model for End Stage Liver Disease [MELD] score), female gender was the main predictor of loss of BMD at LS only (OR 4.80, 95% CI [1.47-15.73], P = 0.01).

Conclusions

The study showed that cirrhotic patients are at increased susceptibility of having decreased BMD, particularly at the LS and it highlights the need for preventive measures, especially for female patients.

Authors+Show Affiliations

College of Medicine, Alfaisal University, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.College of Medicine, Alfaisal University, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.College of Medicine, Alfaisal University; Liver Transplantation and Hepatobiliary Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.Department of Family Medicine, Section of Gastroenterology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.Department of Medicine, Section of Gastroenterology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.Department of Medicine, Section of Gastroenterology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

29943736

Citation

Muhsen, Ibrahim N., et al. "Bone Mineral Density Loss in Patients With Cirrhosis." Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association, vol. 24, no. 6, 2018, pp. 342-347.
Muhsen IN, AlFreihi O, Abaalkhail F, et al. Bone mineral density loss in patients with cirrhosis. Saudi J Gastroenterol. 2018;24(6):342-347.
Muhsen, I. N., AlFreihi, O., Abaalkhail, F., AlKhenizan, A., Khan, M., Eldali, A., & Alsohaibani, F. (2018). Bone mineral density loss in patients with cirrhosis. Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association, 24(6), 342-347. https://doi.org/10.4103/sjg.SJG_74_18
Muhsen IN, et al. Bone Mineral Density Loss in Patients With Cirrhosis. Saudi J Gastroenterol. 2018 Nov-Dec;24(6):342-347. PubMed PMID: 29943736.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bone mineral density loss in patients with cirrhosis. AU - Muhsen,Ibrahim N, AU - AlFreihi,Omar, AU - Abaalkhail,Faisal, AU - AlKhenizan,Abdullah, AU - Khan,Mohammed, AU - Eldali,Abdelmoneim, AU - Alsohaibani,Fahad, PY - 2018/6/27/pubmed PY - 2019/1/23/medline PY - 2018/6/27/entrez KW - Bone mineral densitometry KW - chronic liver disease KW - cirrhosis KW - osteopenia KW - osteoporosis SP - 342 EP - 347 JF - Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association JO - Saudi J Gastroenterol VL - 24 IS - 6 N2 - Background/Aims: Evidence of increased risk of osteoporosis and osteopenia in chronic liver disease and cirrhosis is inconsistent. This study aims to investigate this relationship and to identify the predictors of increased loss of bone mineral density in Saudi patients. Patients and Methods: One hundred and sixty-four patients and controls who are age and gender matched, were included in this study with 1:1 ratio. Patients' included in this study were adults with confirmed liver cirrhosis. Bone mineral densitometry (BMD) at both lumbar spine (LS) and femoral neck (FN) were collected for both groups. Univariate and multivariate regression analyses were performed to identify predictors of BMD loss. Results: Results showed that cirrhotic patients are at higher risk of developing osteoporosis or osteopenia at LS (OR 2.23, 95% CI [1.19-4.19], P = 0.01) but not at FN, when compared to control sample. Patients with cirrhosis were found to have lower vitamin D and PTH levels (P = 0.0005) and (P = 0.006), respectively. Of the possible predictors tested (gender, age, body mass index [BMI], phosphorus, calcium, parathyroid hormone (PTH), vitamin D, and Model for End Stage Liver Disease [MELD] score), female gender was the main predictor of loss of BMD at LS only (OR 4.80, 95% CI [1.47-15.73], P = 0.01). Conclusions: The study showed that cirrhotic patients are at increased susceptibility of having decreased BMD, particularly at the LS and it highlights the need for preventive measures, especially for female patients. SN - 1998-4049 UR - https://www.unboundmedicine.com/medline/citation/29943736/Bone_mineral_density_loss_in_patients_with_cirrhosis_ L2 - http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2018;volume=24;issue=6;spage=342;epage=347;aulast=Muhsen DB - PRIME DP - Unbound Medicine ER -