Changes in Serum Bone Metabolism Markers after Living Donor Liver Transplantation (LDLT) and Their Association with Fracture Occurrences

Abstract

Living donor liver transplantation (LDLT) is lifesaving, but can lead to osteoporosis and fractures. In our 3-year study of 25 LDLT recipients, we observed significant reductions in lumbar spine and femoral neck T scores, along with bone resorption marker reductions and liver regeneration marker increases. Serum calcium levels increased, while osteoprotegerin (OPG) decreased and Dickkopf-related protein 1 (DKK-1) increased. Patients who suffered fractures within 3 years of LDLT had higher serum OPG, lower serum nuclear factor kappa B ligand (RANKL), a higher OPG/RANKL ratio and higher serum DKK-1 levels. OPG, RANKL, OPG/RANKL ratio and DKK-1 levels before LDLT predicted hip or spine fractures within three years after LDLT. Further research is necessary to determine the optimal level of osteoclastic activity for preventing fracture onset.

Effects of Adding Extracorporeal Shockwave Therapy (ESWT) to Platelet-Rich Plasma (PRP) among Patients with Rotator Cuff Partial Tear: A Prospective Randomized Comparative Study

“…For non-parametric within-group comparisons, the Friedman test was utilized for assessing repeated measurements of continuous variables, and the Wilcoxon signed-rank test was applied for post hoc analysis [14,28]. For parametric within-group comparisons, the repeated measures ANOVA test was employed for the assessment of repeated withingroup measurements for continuous variables, and the Fisher's least significant difference (LSD) test was applied for post hoc analysis.…”

Dickkopf-1 (DKK1) blockade mitigates osteogenesis imperfecta (OI) related bone disease

“…The quantification of serum DKK1 concentrations was achieved employing an ELISA kit (Thermo Fisher Scientific, Waltham, MA, USA), following the manufacturer’s stipulated guidelines. Bone mineral density (BMD) and T-score values within the lumbar spine and hip regions were assessed through dual-energy X-ray absorptiometry (DEXA) (Hologic ODR 4500A, Waltham, MA, USA), following our previous protocol (Kuo et al 2023 ). The Spearman correlation coefficient was employed to gauge the strength of correlation between serum DKK1 concentration and T-score values among the OI patients.…”