Abnormal bone mineral density observed in liver cirrhosis patients

A new study published in Journal of Association of The Physicians of India suggests that a large percentage of individuals with liver cirrhosis have abnormal bone mineral density (BMD).

The last stage of chronic liver disease, cirrhosis, causes the normal liver architecture to be distorted by the development of large nodules, vascular reorganization, and the deposition of an extracellular matrix. The term "hepatic osteodystrophy" (HO) describes the changes in bone mineral metabolism that are seen in people with chronic liver illness. Two widely used scoring methods, the CTP score and the model for end-stage liver disease, are used to determine the severity of chronic liver disease. Vaibhav Shukla and his team undertook the current research with the goal of determining how the degree of liver cirrhosis and bone mineral density are related.

It was a case-control investigation. The study comprised 35 confirmed cases of liver cirrhosis and 35 age- and sex-matched controls. Dual-energy X-ray absorptiometry (DEXA) was used to evaluate BMD at the lumbar spine and hip joint. The severity of liver cirrhosis was evaluated using the Child-Turcotte-Pugh (CTP) score.

The key findings of this study were:

1. Twenty-five of the 35 cirrhosis patients exhibited osteopenia or osteoporosis.

2. At the hip joint, the mean T-score in patients was 1.47 by 1.62 and 0.56 by 1.67 in controls (p 0.001).

3. The average T-score found in the lumbar spine was 1.33 1.66 while it was 0.41 1.67 in the control group (p < 0.001).

4. CTP scores and BMD showed a strong unfavorable connection.

This study showed an inverse relationship between BMD and the severity of cirrhosis. Higher CTP scores, lower vitamin D levels, greater PTH levels, and patients with cirrhosis were significant risk factors for aberrant BMD in the current investigation.

Reference: 

Shukla V, Fatima J, Siddiqui Z, et al. Study of Correlation of Bone Mineral Density with Severity of Liver Cirrhosis. J Assoc Physicians India. 10.5005/japi-11001-0257