MELD score, insulin-like growth factor 1 and cytokines on bone density in end-stage liver disease

Mitchell, Rebecca; Mcdermid, J.; Mang, M.; Chik, Constance L.

doi:10.4254/wjh.v3.i6.157

Cited by 15 publications

(5 citation statements)

References 35 publications

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“…In accordance with our findings, another recent study by Mitchell et al failed to detect an association between serum cytokines IL-6 and TNF α and bone mineral density or bone turnover and levels of IL-6 and TNF did not differ between those with and without reduced bone density [ 24 ]. However, they found that low body mass index (BMI), increased bone turnover, and low IGF-1 were independent predictors of low spinal bone density.…”

Section: Discussionsupporting

confidence: 92%

The Role of Serum Cytokines in the Pathogenesis of Hepatic Osteodystrophy in Male Cirrhotic Patients

Soylu

Tuğlu

Arikan

et al. 2012

Gastroenterology Research and Practice

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Objective. In this study, we aimed to investigate the possible role of serum cytokines in the development of hepatic osteodystrophy. Matherial and Methods. 44 consecutive male cirrhotic patients (17 alcoholic, 20 hepatitis B, 7 hepatitis C), 15 age- and sex-matched chronic alcoholics without liver disease, and 17 age- and sex-matched healthy controls were included in the study during one year period. Bone mineral density was measured by dual X-ray absorptiometry in the lumbar vertebrate and femoral neck. Serum interleukin levels were measured by ELISA method. Results. Although osteopenia frequency between our cirrhotic patients was 20%, there was no difference in T-scores among the controls and other groups. Serum interleukin-1, interleukin-8, and tumor necrosis factor-alpha levels were not different between all groups. Serum interleukin-2 and interleukin-6 levels were higher in the cirrhotics than controls (P < 0.001). However, there were no significant difference between osteopenic and nonosteopenic cirrhotics. Conclusion. According to the results of the study in this small population of 44 male cirrhotic patients, frequency of hepatic osteopenia is small and serum interleukins 1, 2, 6, 8, and tumor necrosis factor-alpha may not play a role in the pathogenesis of hepatic osteodystrophy. Further studies in which large number of patients involved are necessary in this field.

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Section: Discussionsupporting

confidence: 92%

The Role of Serum Cytokines in the Pathogenesis of Hepatic Osteodystrophy in Male Cirrhotic Patients

Soylu

Tuğlu

Arikan

et al. 2012

Gastroenterology Research and Practice

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“…On a molecular level, low-turnover osteoporosis in CLD patients is commonly associated with toxic effects of biliary stasis and copper/iron accumulation on differentiation, maturation, and proliferation of osteoblasts (Figure 3 )[ 68 - 70 ]. Also, previous studies suggested that osteoblast dysfunction in patients with cholestatic forms of CLD could be mediated by insulin growth factor-1 or oncofetal fibronectin[ 66 , 70 , 71 ], while direct toxic effects of alcohol on osteoblastic function contribute to bone loss among patients within alcohol-induced CLD[ 72 , 73 ].…”

Section: The Molecular Mechanisms Involved In Etiopathogenesis Of Cld...mentioning

confidence: 99%

Bone loss in chronic liver diseases: Could healthy liver be a requirement for good bone health?

Jadžić¹,

Djonić²

2023

World J Gastroenterol

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Given that the liver is involved in many metabolic mechanisms, it is not surprising that chronic liver disease (CLD) could have numerous complications. Secondary osteoporosis and increased bone fragility are frequently overlooked complications in CLD patients. Previous studies implied that up to one-third of these individuals meet diagnostic criteria for osteopenia or osteoporosis. Recent publications indicated that CLD-induced bone fragility depends on the etiology, duration, and stage of liver disease. Therefore, the increased fracture risk in CLD patients puts a severe socioeconomic burden on the health system and urgently requires more effective prevention, diagnosis, and treatment measures. The pathogenesis of CLD-induced bone loss is multifactorial and still insufficiently understood, especially considering the relative impact of increased bone resorption and reduced bone formation in these individuals. It is essential to note that inconsistent findings regarding bone mineral density measurement were previously reported in these individuals. Bone mineral density is widely used as the “golden standard” in the clinical assessment of bone fragility although it is not adequate to predict individual fracture risk. Therefore, microscale bone alterations (bone microstructure, mechanical properties, and cellular indices) were analyzed in CLD individuals. These studies further support the thesis that bone strength could be compromised in CLD individuals, implying that an individualized approach to fracture risk assessment and subsequent therapy is necessary for CLD patients. However, more well-designed studies are required to solve the bone fragility puzzle in CLD patients.

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“…insulin like growth factor 1, IGF-1) ili onkofetalni fibronektin (engl. oncofetal fibronectin), ali i posledica toksičnog efekta staze bilirubina i žučnih kiselina koja može biti prisutna kod pacijenata sa alkoholnom cirozom jetre (slika 3) (56)(57)(58). Uz to, nedavno je objavljeno da povećana koncentracija sklerostina, kao ključnog regulatora Wnt/ß-katenin signalnog puta koji reguliše stvaranje kostiju, može biti uključena u patogenezu osteoporoze kod ACJ pacijenata (42,59).…”

Section: Mineralna Gustina Kostiju U Alkoholnoj Cirozi Jetreunclassified

Compromised bone strength in patients with alcoholic liver cirrhosis

Jadžić¹,

Đonić²

2020

Medicinski podmladak

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Osteoporoza i/ili osteopenija su česte komplikacije alkoholne bolesti jetre, sa posebnim značajem u njenom ireverzibilnom stadijumu (engl. alcoholic liver cirrhosis – ALC). U ovoj publikaciji je predstavljen pregled savremene literature o učestalosti osteoporoze, povećanom riziku od preloma kosti, promenama mineralne gustine i mikrostrukture kostiju, kao i o etio-patogenetskim mehanizmima koji dovode do smanjenja kvaliteta kosti kod pacijenata sa ALC-om. Zabeleženo je da osteoporoza može biti prisutna kod značajnog broja ALC bolesnika, naročito u slabinskom delu kičmenog stuba. Identifikovano je više faktora rizika, kao i etio-patogenetskih mehanizama povezanih sa gubitkom mineralne gustine kosti kod bolesnika sa alkoholnom i cirozama druge etiologije. Određeni autori tvrde da je dominantan mehanizam gubitka koštane mase usporeno osteoblastno stvaranje kosti, dok drugi rezultati sugerišu pojačanu razgradnju koštanog matriksa kao dominantniji mehanizam u nastanku skeletnih oštećenja kod ALC bolesnika. Povećana koštana fragilnost i sklonost ka patološkim prelomima značajno utiču na životni vek i kvalitet života pacijenata sa ALC-om. Stoga se preporučuje da osteološki skrining i procena rizika od frakture budu obavezni deo individualnog pristupa lečenju bolesnika sa alkoholnom cirozom jetre.

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MELD score, insulin-like growth factor 1 and cytokines on bone density in end-stage liver disease

Abstract: Osteopenia/osteoporosis is common in advanced liver disease. Low serum IGF-1 is weakly predictive but serum cytokine and MELD score fail to predict the severity of bone disease.

Cited by 15 publications

References 35 publications

The Role of Serum Cytokines in the Pathogenesis of Hepatic Osteodystrophy in Male Cirrhotic Patients

The Role of Serum Cytokines in the Pathogenesis of Hepatic Osteodystrophy in Male Cirrhotic Patients

Bone loss in chronic liver diseases: Could healthy liver be a requirement for good bone health?

Compromised bone strength in patients with alcoholic liver cirrhosis

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