Low bone turnover state in primary biliary cirrhosis

Stellon, Anthony; Webb, A. J.; Compston, Juliet; Williams, Roger

doi:10.1002/hep.1840070127

Cited by 127 publications

(50 citation statements)

References 18 publications

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“…Indeed, impaired osteoblast function, resulting in lower mean wall thickness and a defect in matrix synthesis, as well as a low bone formation rate, that affects, mainly, trabecular one, have been reported. These data are consistent with the decreased serum levels of osteocalcin, a biochemical marker of bone formation [6].…”

Section: Pathophysiology Of Osteoporosis In Chronic Liver Diseasessupporting

confidence: 86%

Osteodystrophy in chronic liver diseases

et al. 2012

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Osteoporosis and osteomalacia are, to date, among the most common metabolic diseases in the world. Lately, an association between metabolic bone diseases and chronic liver disease has been increasingly reported, inducing many authors to create a new nosographic entity known as 'hepatic osteodystrophy. ' The importance of such a condition is further increased by the morbidity of these two diseases, which greatly reduce the quality of life because of frequent fractures, especially vertebral and femoral neck ones. For this reason, early identification of high-risk patients should be routinely performed by measuring bone mass density. The explanation for the association between bone diseases and chronic liver disease is still uncertain, and involves many factors: from hypogonadism to use of corticosteroid drugs, from genetic factors to interferon therapy. To date, few studies have been conducted, and all with a small number of patients to establish definitive conclusions about the possible treatment, but some evidence is beginning to emerge about the safety and efficacy of bisphosphonates.

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Section: Pathophysiology Of Osteoporosis In Chronic Liver Diseasessupporting

confidence: 86%

Osteodystrophy in chronic liver diseases

et al. 2012

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“…Diminished BMD has been reported in patients with alcoholic liver disease, [10][11][12][13][14] alcoholic subjects without cirrhosis, 15,16 patients with pri- mary biliary cirrhosis, [3][4][5] and patients with hemochromatosis, 8,9 but little has been published on viral cirrhotic patients without a history of alcohol consumption. In our study, bone densities in the FN and LS were significantly lower in viral cirrhotic patients than in the reference population, and this reduction was more severe in LS (trabecular bone) than FN (cortical bone), probably because the rate of turnover in cortical bone is much lower than in trabecular bone.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2] Several studies have shown diminished bone formation rates in patients with cholestatic liver disease, [3][4][5] corticosteroid-treated chronic active hepatitis, [6][7] hemochromatosis, [8][9] and alcoholic liver disease. [10][11][12][13][14] Some studies also showed reduced bone formation rates in alcoholic subjects without cirrhosis.…”

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confidence: 99%

Bone mineral density, serum insulin-like growth factor I, and bone turnover markers in viral cirrhosis

et al. 1998

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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.)

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“…Thus in some studies, the changes were predominantly those of low bone turnover and reduced bone formation at the cellular level, 30,59,60 whilst others have also reported evidence of increased turnover and resorption. [61][62][63][64] Biochemical markers of bone formation have been reported to be decreased 51 or normal 55 and resorption markers increased.…”

Section: Pre-existing Bone Diseasementioning

confidence: 99%

Osteoporosis after liver transplantation

Compston

2003

Liver Transplantation

107

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L iver transplantation is now a well-established procedure with 5-year survival rates of over 70% in most centers. 1 The quality of life for the majority of survivors is good, but a number of long-term complications have been described, many of which are related to immunosuppressive therapy. The main skeletal complications are avascular necrosis and osteoporosis, of which the latter is most common and may result in significant morbidity and mortality.Studies performed early in the history of liver transplantation documented rapid bone loss and a high incidence of fragility fractures, but there is evidence that the frequency of osteoporosis after transplantation may be decreasing, providing important insights into its pathogenesis. This review considers the clinical features, pathogenesis, pathophysiology, and management of osteoporosis after liver transplantation and considers the lessons that may be learnt from changes in its natural history. Clinical FeaturesOsteoporosis is characterised by reduced bone mass and disruption of bone architecture, leading to decreased bone strength and an increase in the risk of fragility fracture particularly at the wrist, hip and spine. 2 These fractures are associated with a high morbidity and increased mortality and often have devastating effects on quality of life.

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Low bone turnover state in primary biliary cirrhosis

Cited by 127 publications

References 18 publications

Osteodystrophy in chronic liver diseases

Osteodystrophy in chronic liver diseases

Bone mineral density, serum insulin-like growth factor I, and bone turnover markers in viral cirrhosis

Osteoporosis after liver transplantation

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