Osteoporosis in chronic liver disease

Rose, J.D.R.; Crawley, E.O.; Evans, W. D.; Evans, Carol; Church, Hannah; Smith, Peter; Compston, J.

doi:10.1016/8756-3282(87)90158-x

Cited by 7 publications

(3 citation statements)

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“…'-20 Most of these relate to those who have had a bone biopsy, although non-invasive skeletal measurements have also been done in small numbers of selected patients.' 8912 [21][22][23][24][25][26][27][28][29][30][31] To our knowledge no such studies have been carried out in unselected ambulant individuals.…”

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confidence: 99%

Osteoporosis and skeletal fractures in chronic liver disease.

Diamond

Stiel

Lunzer

et al. 1990

Gut

190

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In order to determine the prevalence and severity of hepatic osteodystrophy by noninvasive means we compared 115 consecutive ambulant patients with histologically proven chronic liver disease to 113 age and sex matched control subjects. Methods used included the assessment offracture prevalence rates, spinal radiography, and measurements of bone mineral density in the spine and the forearm. Spinal and peripheral fractures were more prevalent in the patients than in the control subjects (p<003 and p<001 respectively).

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confidence: 99%

Osteoporosis and skeletal fractures in chronic liver disease.

Diamond

Stiel

Lunzer

et al. 1990

Gut

190

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“…Rode et al of Australia works with 158 patient where cirrhosis (n= 65) and no cirrhosis (n= 93). They categorize the patients in Viral (60), NASH (23), Alcoholic (22), Autoimmune (12), Haemochromatosis (9), Wilson's (2) Cholestatic (5) and others (25) [8]. Among the study population, 52% male.…”

Section: Introductionmentioning

confidence: 99%

The Concentration Of 25-Hydroxy Vitamin D In Chronic Liver Disease And Its Correlation With Severity

Ahmed¹,

Paul²,

Kabi³

et al. 2021

JGPHD

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Background: Chronic liver disease (CLD is a common disease all over the world and the major cliological factors for the causation of disease are HBV and HCV in this country and Alcoholic liver disease in the western world. With the availability of the modern treatment, the life expectancy is increased now a days. But the long term complications are now evident. One of the complications is hepatic osteodystrophy which is associated with deficiency of vitamin D. Vitamin D undergoes hepatic 25-hydroxylation, but as the hepatic parenchyma is jeopardized so the metabolic activation of this vitamin is impaired. Vitamin D deficiency is highly prevalent in CLD patients and vitamin D level is inversely related to the severity of the disease. Objective: To assess the concentration of 25-hydroxy vitamin D in chronic liver disease patient in different etiology and to study the relationship of level of 25(OH) D in different stages of the disease according to Child-Pugh classification. Methods: This cross sectional study was carried out in the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka during the period of April 2015 to March 2016. Patient attending the Gastroenterology Department who fulfill the inclusion criteria with cirrhosis of liver were initially be enrolled for the study. Their clinical history, examination and initial investigation report were noted in the standard data sheet. After explaining the study objective, informed consent was taken. The diagnosis of liver cirrhosis was made by combination of clinical features, blood profile and transabdominal ultrasound. Endoscopy of the upper GIT was done to see the presence of oesophageal or gastric varices which is a sign of increase portal pressure. Transabdominal ultrasound demonstrated a shrunken liver with increase echogenicity, with or without splenomegally and presence or absence of ascites. Stages of liver disease were assessed by Child-Pugh scoring system. Level of 25(OH) D was measured from blood with the permission of the Department of Bio-chemistry. Data was collected using a structered data sheet. Results: Out of 85 patients, male were 61 (71.8%) and female were 24 (28.2%). Mean age was 53.0 ± 10.7 years within tin- range of 25-70 years. More than 90.0% patient* had abates and anorexia. Eighty percent patients had weight loss and 71.8% patients had Jaundice. More than 40.0% patients had abdominal pain and melaena. Sixty (77.9%) patients had history of blood transfusion and 73 (94.8%) patients had previous hospitalization, Most of the patients had anaemia (97.6%) and Splenomegaly (92.9%). More than 50.0% patients had jaundice (61.2%), Leukonychia (61.2%) and hone pain (52.9%). Mean s, vitamin 25(OH) D was 16.29 ± 7.96 in 69 HBV patients and 20.14 ± 9.76 in 16 HCV patients. In this study, 28.2% patients were in child Pugh A, 36.4% in child Pugh B and 32.9% in child Pugh C stages. Mean s. vitamin 25(OH) D were 27.12 ± 6.11, 15.97 ± 5.40 and 9.57 ± J.I5 in Child-pugh A, Child-pugh B and Child-pugh C stages respectively. Mean s. vitamin 25(OH) D was gradually decreased as the changes of stage from lower to higher. Conclusion: Vitamin D deficiency is highly prevalent in patients with CLD and inversely correlated with disease severity. In the case of chronic liver diseases, vitamin D seems to modulate the innate and adaptive immune system, which explains the association. In fact, clinical studies suggest that these parameters may improve with vitamin D supplementation. So, monitoring of S. 25(OH) D is reasonable in CLD patient.

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“…e study outcome also suggest that patient with cirrhosis were more likely to be de cient in 25(OH) D (75%, P= 0.028). 8 Miroliace el al. of Iran, works with CLD patient where HBV (n=26), HCV (n=28), AIH (n=19), Cryptogenic (n=17) with 40 healthy controls.…”

Section: Introductionmentioning

confidence: 99%

The Concentration of 25-Hydroxy Vitamin D in Chronic Liver Disease and its’ Correlation with Severity

Ahmed¹,

Paul

Hasan³

et al. 2021

Bangladesh Med J

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Chronic Liver Disease (CLD) is a common disease all over the world and the major biological factors are Hepatitis B virus (HBV) and Hepatitis C virus (HCV) in Bangladesh and Alcoholic liver disease in the western world. Life expectancy of CLD patient is increasing now a days by available modern treatment; but the long term complications are now evident. Hepatic osteodystrophy is one of the most common complication which is associated with vitamin D deficiency. Vitamin D undergoes hepatic 25-hydroxylation, but as the hepatic parenchyma is jeopardized so the metabolic activation of this vitamin is impaired. The aim of the study was to measure the concentration of 25-hydroxy vitamin D 25(OH) D in CLD patient in different etiology and to find out the relationship of level of 25(OH) D in different stages of the disease according to Child-Pugh classification. This cross sectional study was carried out in the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during the period of April 2015 to March 2016. Patients attending the Gastroenterology Department with cirrhosis of liver and who fulfilled the inclusion criteria were initially enrolled for the study. Study objectives were explained and informed consent was taken from patients prior to record their clinical history, examination findings and initial investigation reports in the standard data sheet. The diagnosis of liver cirrhosis was made by combination of clinical features, blood profile and trans abdominal ultrasonography (T. USG). Endoscopy of the upper GIT was also done to see the presence of oesophageal or gastric varices which is a sign of increase portal pressure. Stages of CLD were assessed by Child-Pugh scoring system and level of 25(OH) D was measured from blood with the help of the Department of Bio-chemistry. Data was collected using a structured data sheet and analyzed by SPSS. Out of 85 patients, male-female ratio was 3:1 and mean age was 53.0 ± 10.7 year within the range of 25-70 years. Most of the patients had acites 92.9% and anorexia 90.6%; where four-fifth patients had weight loss and more than one third had Jaundice. Nearly half of the patients had abdominal pain and 42.4% had melaena. Four-fifth patients had history of blood transfusion and most of them had H/O hospitalization 94.8%, anaemia (97.6%) and Splenomegaly 92.9%. More than half (52.9%) of patients had bone pain; where jaundice 61.2% and Leukonychia 61.2% were detected in equal number of patients. Mean vitamin 25(OH) D was 16.29 ± 7.96 in 69 HBV patients and 20.14 ± 9.76 in 16 HCV patients. In this study, 28.2% patients were in child Pugh A, 36.4% in child Pugh B and 32.9% in child Pugh C stages. Mean vitamin 25(OH) D were 27.12 ± 6.11, 15.97 ± 5.40 and 9.57 ± 1.I5 in Child-pugh A, Child-pugh B and Child-pugh C stages respectively. Mean vitamin 25(OH) D was observed at decreased level as the changes of stage from lower to higher. Vitamin D deficiency was highly prevalent in patients with CLD and inversely correlated with disease severity. In the case of chronic liver diseases, vitamin D seems to modulate the innate and adaptive immune system, which explains the association. This study suggest that these parameters may improve with vitamin D supplementation. Monitoring of S. 25(OH) D is reasonable in CLD patient. Bangladesh Med J. 2020 Sept; 49(3) : 35-42

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Osteoporosis in chronic liver disease

Cited by 7 publications

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Osteoporosis and skeletal fractures in chronic liver disease.

Osteoporosis and skeletal fractures in chronic liver disease.

The Concentration Of 25-Hydroxy Vitamin D In Chronic Liver Disease And Its Correlation With Severity

The Concentration of 25-Hydroxy Vitamin D in Chronic Liver Disease and its’ Correlation with Severity

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