The Frequency of Osteoporosis in Patients with Liver Cirrhosis in Erzurum and Surrounding

Year 2021, Volume: 2 Issue: 2, 87 - 92, 15.09.2021

Burak Menekşe , Ömer Topdağı , Tuğba Sanalp Menekşe

Abstract

Abstract
Here, it was aimed to investigate whether the frequency of osteoporosis in patients with liver cirrhosis increases compared to the healthy population. DEXA (dual energy x-ray absorptiometry) test was applied to 50 patients with liver cirrhosis and 50 healthy people of similar age who were followed in the Gastroenterology Clinic of Atatürk University Medical Faculty Hospital. L1-L4 T scores were determined from the DEXA test results. In addition, age, gender, disease etiology, complications, Child-Pugh score, sodium-corrected MELD (Model for End-stage Liver Disease) score, serum vitamin D and corrected serum calcium levels were obtained from all patients. The mean age of the patient group with liver cirrhosis was 58,18±10,67 years. The mean age of the control group was 59,82±11,54. When compared in terms of age distribution, no statistically significant difference was found between the two groups (p>0,05). The mean DEXA test T scores of the patient group with liver cirrhosis was -1,58±1,44 SD and the mean of the DEXA test T scores of the control group was calculated as -1,01±1,32 SD. When compared in terms of T scores, a statistically significant decrease was found in the patients with liver cirrhosis compared to the control group (p<0,05).
Results: Liver cirrhosis may be a risk factor for the development of osteoporosis and these patients should be followed up for osteoporosis.

Keywords

Liver cirrhosis, osteoporosis,, chronic hepatitis B infection

References

• 1. Tsochatzis EA, Bosch J, Burroughs AK. Liver cirrhosis. The Lancet. 2014; 383(9930):1749-1761.
• 2. Anthony P, Ishak K, Nayak N, et al. The morphology of cirrhosis: definition, nomenclature, and classification. Bulletin of the World Health Organization. 1977; 55(4):521.
• 3. Hoeper MM, Krowka MJ, Strassburg CP. Portopulmonary hypertension and hepatopulmonary syndrome. The Lancet. 2004; 363(9419):1461-1468.
• 4. Rouillard S, Lane NE. Hepatic osteodystrophy. Hepatology. 2001; 33(1):301-307.
• 5. Lindsay R, Cosman F. Osteoporosis. In: Jameson JL, Fauci AS, Kasper SL, et al, editors. Harrison's Principles Of Internal Medicine. 17th ed. Basım yeri: McGraw Hill Medical Books. 2013; p2488-504.
• 6. Yavuz DG, Akalın A, Alış M ve ark. Osteoporoz ve Metabolik Kemik Hastalıkları Tanı ve Tedavi Kılavuzu 2018. [Erişim Tarihi: 01.03.2020]. Web sayfası: http://temd.org.tr/admin/uploads/tbl_kilavuz/20190506164125-2019tbl_ kilavuz0f7419cd64.pdf.
• 7. Asomaning K, Bertone-Johnson ER, Nasca PC, et al. Bone mineral density examination. J Women's Health. 2006; 15(9): 1028-1034.
• 8. Uluçay V, Saka M. Karaciğer sirozu ve hepatik ensefalopatide nutrisyon. Güncel Gastroenterol Derg. 2016; 20(3): 305-316.
• 9. Enomoto H, Ueno Y, Hiasa Y, et al. Transition in the etiology of liver cirrhosis in Japan: a nationwide survey. J Gastroenterol. 2019: 1-10.
• 10. Kim D, Li AA, Perumpail BJ, et al. Changing trends in etiology‐based and ethnicity‐based annual mortality rates of cirrhosis and hepatocellular carcinoma in the United States. Hepatology. 2019; 69(3): 1064-1074.
• 11. Bacon BR. Cirrhosis and Its Complications. In: Jameson JL, Fauci AS, Kasper SL, et al, editors. Harrison's Principles Of Internal Medicine. 20th ed. Basım yeri: McGraw Hill Medical Books. 2018; 5877-5905.
• 12. Lai JC, Rahimi RS, Verna EC, et al. Frailty associated with waitlist mortality independent of ascites and hepatic encephalopathy in a multicenter study. Gastroenterology. 2019; 156(6): 1675-1682.
• 13. Sherpa TW, Pathak R, Khadga PK, et al. Nutritional Assessment of Patients with Liver Cirrhosis by Nutrition Screening Tool and Anthropometry at a Tertiary Care Center. JIOM Nepal. 2019; 41(2): 21-25.
• 14. Oka H, Tamori A, Kuroki T, et al. Prospective study of α‐fetoprotein in cirrhotic patients monitored for development of hepatocellular carcinoma. Hepatology. 1994; 19(1): 61-66.
• 15. Lee S-W, Lee T-Y, Chang C-S. Independent factors associated with recurrent bleeding in cirrhotic patients with esophageal variceal hemorrhage. Digest dis sci. 2009; 54(5): 1128.
• 16. Kraja B, Mone I, Akshija I, et al. Predictors of esophageal varices and first variceal bleeding in liver cirrhosis patients. World J Gastroentero. 2017; 23(26): 4806-4814.
• 17. Wei MT, Le AK, Chang MS, et al. Antiviral therapy and the development of osteopenia/osteoporosis among Asians with chronic hepatitis B. J Med Virol. 2019; 91(7): 1288-1294.
• 18. Lim LS, Fink HA, Blackwell T, et al. Loop diuretic use and rates of hip bone loss and risk of falls and fractures in older women. J Am Geriatr Soc. 2009; 57(5): 855-862.
• 19. Barbu E-C, Chitu-Tisu C-E, Lazar M, et al. Hepatic Osteodystrophy: A Global (Re) View of the Problem. Acta Clin Croat. 2017; 56(3): 512-526.
• 20. Karoli Y, Karoli R, Fatima J, Manhar M. Study of hepatic osteodystrophy in patients with chronic liver disease. J Clin Diagn Res. 2016; 10(8): 31-34.
• 21. Goral V, Simsek M, Mete N. Hepatic osteodystrophy and liver cirrhosis. World J Gastroentero. 2010; 16(13): 1639-1643.