Previous studies suggest that low bone mass is a complication of alcoholic liver disease. Nevertheless, little is known about bone mass and bone metabolism in viral cirrhosis. To evaluate the prevalence and magnitude of hepatic osteopenia in these patients, bone remodeling status, and its relationship with the severity of liver disease and serum levels of insulin-like growth factor I (IGF-I), we studied 32 consecutive patients with viral cirrhosis and no history of alcohol intake. Bone mineral density (BMD) was measured by dual x-ray absorptiometry in the lumbar spine (LS) and femoral neck (FN), and the values were expressed as the z score. Bone metabolism markers and hormone profiles were measured. Patients with viral cirrhosis showed reduced BMD in all sites (LS: ؊1.27 ؎ 1.06, P F .001; FN: ؊0.48 ؎ 0.96; P F .01). Of the 32 patients, 53% met the diagnostic criteria for osteoporosis. In patients, urine deoxypyridinoline (D-Pyr) as a marker of bone resorption and serum bone alkaline phosphatase (b-AP) as a marker of bone formation were significantly higher than in control subjects (P F .001 and P F .01, respectively). Serum IGF-I was lower than in control subjects (P F .001), and significant differences were also found between patients with and without osteoporosis (P F .05). BMD in LS correlated with severity of the disease, with serum levels of IGF-I, and with urine D-Pyr. Our findings show that viral cirrhosis is a major cause of osteoporosis in men, and that low serum IGF-I levels seem to play a role in the bone mass loss in these patients. The biochemical markers of bone remodeling suggest high-turnover osteoporosis in patients with viral cirrhosis. (HEPATOLOGY 1998;28:695-699.)

Liver cirrhosis is a risk factor for osteoporosis. Nevertheless, little is known about the mechanisms of bone mass loss in patients with viral cirrhosis. TNFalpha is a potent bone-resorbing agent. Serum concentrations of soluble TNF receptor p55 (sTNFR-55) correlate with clinical activity in liver cirrhosis. Our aim was to evaluate the possible role of sTNFR-55 in the pathogenesis of osteoporosis in patients with viral cirrhosis and its relationship with bone turnover markers. We studied 40 consecutive patients with viral cirrhosis and no history of alcohol intake and 26 healthy volunteers. Bone mineral density (BMD) was measured by dual x-ray absorptiometry in the lumbar spine (LS) and femoral neck (FN). Patients with viral cirrhosis had reduced BMD (expressed as the z-score) in all sites [LS, -1.5 +/- 0.22 (P < 0.001); FN, -0.37 +/- 0.15 (P < 0.01)]. Serum concentrations of sTNFR-55 and urinary deoxypyridinoline, a biochemical marker of bone resorption, were significantly higher in patients with osteoporosis than in patients without osteoporosis (P < 0.001 and P < 0.05, respectively). Serum levels of sTNFR-55 correlated inversely with BMD in LS (r = -0.62; P < 0.005) and FN (r = -0.47; P < 0.05) and positively with urinary deoxypyridinoline (r = 0.72, P < 0.001). Our findings show that high serum concentrations of sTNFR-55 play a role in the pathogenesis of viral cirrhosis-associated bone mass loss and provide evidence of increased bone resorption related to the high serum sTNFR-55 levels.

There is a relation between activation of the cellular immunity and osteoporosis in AC. Bone mass loss could be related to the increased bone resorption found in these patients.

No abstract

The main aim of the work is to assess physical parameters of forest woodchips and their impact on the prices achieved by the supplier in transactions with a power plant. During fragmentation of logging residue, high content of green matter and contaminants negatively impacts the quality parameters that serve as basis for settlements. The analysis concerns data on the main parameters -water content, fuel value, sulphur and ash content -from 252 days of deliveries of forest chips to a power plant. The deliveries were realised from forested areas on an average about 340 km from the plant. Average water content and the resultant fuel value of forest chips was within 27-47% and 8.7-12.9 GJ×Mg −1 (appropriately), respectively. They depend on the month in which they are delivered to the power plant. The threshold values for the above-mentioned parameters are set by the plant at a real level and the suppliers have no problems with meeting them. The parameter that is most frequently exceeded is ash content (11.5% of cases). The settlement system does not differentiate on the basis of the transport distance but gives possibility to lower the settlement price when the quality parameters are not met but provides no reward for deliveries with parameters better than the average ones. On the basis of results obtained, it was calculated that average annual settlement price is lower than the contract price by about 0.20 PLN×GJ −1 , which in case of the analysed company may translate into an average daily loss of about 700 PLN.