Hepatic Osteodystrophy: A Global (Re)View of the Problem

Barbu, Ecaterina-Constanţa; Chiţu-Tișu, Cristina-Emilia; Lazăr, Mihai; Olariu, Cristina; Bojincă, Mihai; Ionescu, R; Ion, Daniela Adriana; Bădărău, Ioana Anca

doi:10.20471/acc.2017.56.03.19

Cited by 15 publications

(12 citation statements)

References 40 publications

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“…In addition, in SCD patients we observed a significant correlation between abnormal AST and vertebral fracture, suggesting a possible role of sickle cell related hepatopathy in SBD. Previous studies in other models of hepatic osteodystrophy demonstrated the relationship between hepatic function and bone metabolism, vitamin D levels and bone density [43][44][45]. Inflammatory vasculopathy and chronic hemolysis play a key role in both acute and chronic sickle cell related organ complication [2].…”

Section: Discussionmentioning

confidence: 98%

Development of Algorithm for Clinical Management of Sickle Cell Bone Disease: Evidence for a Role of Vertebral Fractures in Patient Follow-up

Franceschi

Gabbiani

Giusti³

et al. 2020

JCM

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Sickle-cell disease (SCD) is a worldwide distributed hemoglobinopathy, characterized by hemolytic anemia associated with vaso-occlusive events. These result in acute and chronic multiorgan damage. Bone is early involved, leading to long-term disability, chronic pain and fractures. Here, we carried out a retrospective study to evaluate sickle bone disease (SBD) in a cohort of adults with SCD. We assessed bone density, metabolism and turnover. We also evaluated the presence of fractures and the correlation between SCD severity and skeletal manifestations. A total of 71 patients with SCD were analyzed. The mean age of population was 39 ± 10 years, 56% of which were females. We found osteoporosis in a range between 7% and 18% with a high incidence of vertebral fractures. LDH and AST were predictive for the severity of vertebral fractures, while bone density was not. Noteworthy, we identified -1.4 Standard Deviations T-score as the cutoff for detecting the presence of fractures in patients with SCD. Collectively our data allowed us to develop an algorithm for the management of SBD, which may be useful in daily clinical practice to early intersect and treat SBD.

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Section: Discussionmentioning

confidence: 98%

Development of Algorithm for Clinical Management of Sickle Cell Bone Disease: Evidence for a Role of Vertebral Fractures in Patient Follow-up

Franceschi

Gabbiani

Giusti³

et al. 2020

JCM

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“…HO is an osteometabolic disease that presents with low BMD and changes in bone microarchitecture, and it constitutes a reasonable experimental model for evaluating osteoporosis (46). In this model, hepatic impairment leads to metabolic disturbances that causes loss of bone mass (37,38,46,47), however the pathogenesis is not fully A B understood (48). Some studies have shown that decreased bone formation is the predominant mechanism (47), while others point to increased bone resorption as the main cause of bone loss (49).…”

Section: Discussionmentioning

confidence: 99%

Ex vivo vibro-acoustography characterization of osteoporosis in an experimental mice model

Agnollitto¹,

Braz²,

Spirlandeli³

et al. 2021

Quant Imaging Med Surg

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Background: Osteoporosis is a highly prevalent multifactorial osteometabolic disease, classically diagnosed, in vivo, by dual energy X-ray absorptiometry (DXA). This study evaluated osteoporosis, ex vivo, using vibroacoustography (VA), an elastographic technique based on ultrasound radiation force.Methods: Three groups of mice femurs were used: (I) control group (CG), (II) osteoporosis group (OG) and (III) treated osteoporosis group (TOG), in which the animals received pamidronate, an antiresorptive drug. Evaluation was performed in an acoustic tank, using two high frequency focused beams produced by a confocal ultrasonic transducer. A hydrophone registered the low frequency acoustic response (AR) of bone samples. We used micro-computed tomography (microCT) as the reference standard and evaluated the correlation between VA and microCT parameters. Results:The spectral analyses of the ARs with estimated area under the curve (AUC) values (mean; st. dev.) were, respectively, 1.29e -07 and 9.32e -08 for the CG, 3.25e -08 and 2.16e -08 for the OG, and 1.50e -07 and 8.37e -08 for the TOG. VA differentiated the experimental groups (P<0.01) and the results were reproducible [interclass correlation coefficient (ICC): 0.43 (95% CI: 0.15-0.71)]. There was also a statistically significant association between VA and microCT connectivity (Conn.) (r=0.80; P<0.01) and connectivity density (Conn. D) (r=0.76; P<0.01).Conclusions: These results encourage further studies aimed at evaluating the potential use of VA for the diagnosis of osteoporosis as a relatively low-cost and radiation-free alternative to DXA.

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“…There are multiple risk factors for hepatic osteodystrophy in liver disease including genetic factors, vitamin D deficiency and calcium disorders, vitamin K deficiency, IGF-1 deficiency, hyperbilirubinemia, hypogonadism, medication, fibronectin, hyperhomocysteinemia, leptin and lifestyle. 46 Osteoprogenitor cells are reduced in patients with cirrhosis. 47…”

Section: Pathogenesis Of Sarcopenia In Cirrhosismentioning

confidence: 99%

Nutrition in Chronic Liver Disease: Consensus Statement of the Indian National Association for Study of the Liver

Puri¹,

Dhiman

Taneja

et al. 2021

Journal of Clinical and Experimental Hepatology

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Malnutrition and sarcopenia are common in patients with chronic liver disease and are associated with increased risk of decompensation, infections, wait-list mortality and poorer outcomes after liver transplantation. Assessment of nutritional status and management of malnutrition are therefore essential to improve outcomes in patients with chronic liver disease. This consensus statement of the Indian National Association for Study of the Liver provides a comprehensive review of nutrition in chronic liver disease and gives recommendations for nutritional screening and treatment in specific clinical scenarios of malnutrition in cirrhosis in adults as well as children with chronic liver disease and metabolic disorders.

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Hepatic Osteodystrophy: A Global (Re)View of the Problem

Cited by 15 publications

References 40 publications

Development of Algorithm for Clinical Management of Sickle Cell Bone Disease: Evidence for a Role of Vertebral Fractures in Patient Follow-up

Development of Algorithm for Clinical Management of Sickle Cell Bone Disease: Evidence for a Role of Vertebral Fractures in Patient Follow-up

Ex vivo vibro-acoustography characterization of osteoporosis in an experimental mice model

Nutrition in Chronic Liver Disease: Consensus Statement of the Indian National Association for Study of the Liver

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