Risk factors for osteoporosis in patients with end-stage liver disease

Uchida, Shinjiro; Miyaaki, Hisamitsu; Ichikawa, Tatsuki; Taura, Naota; Miuma, Satoshi; Honda, Takeshi; Shibata, Hidetaka; Haraguchi, Masafumi; Senoo, Takemasa; Nakao, Kazuwa

doi:10.3892/br.2016.764

Cited by 7 publications

(6 citation statements)

References 20 publications

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“…In patients with SCD, we confirmed the presence of vitamin D deficiency, despite the oral vitamin D supplementation [30]. Different factors have been invoked to explain the persistent vitamin D deficiency in SCD patients independently from vitamin D supplementation such as (i) the dark skin type present in 50% of our patients that may hinder the effect of solar radiation in vitamin D production [31]; (ii) reduced vitamin D intestinal absorption, most likely related to chronic cholestasis which may affect enterohepatic circulation of bile acids with reduced absorption of liposoluble compounds such as vitamin D [32]; (iii) increased body fat tissue levels in SCD patients could further induce vitamin D deficit by sequestration, thus determining its low bioavailability [12,[33][34][35]. In our cohort, we showed that 72% of patients had vitamin D level <30 ng/mL and that hypovitaminosis D was confirmed even after supplementation.…”

Section: Discussionmentioning

confidence: 99%

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: 99%

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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“…Liver plays a major role in vitamin D metabolism and affects many different cytokines and hormones, including the IGF-1, IL-6, fibronectin, receptor-activator of nuclear factor kappa ligand/osteoprotegerin system, and others. [ 2 15 ] The American Gastroenterology Association (AGA) has concluded in its technical review in 2003 that BMD loss is mild in CLD patients and it is similar to the expected bone mass loss in patients without history of corticosteroids use. [ 8 ] Following the AGA conclusion, more data had accumulated; however, seldom evidence was from the Middle East in general and Saudi Arabia, in particular.…”

Section: Discussionmentioning

confidence: 99%

Bone mineral density loss in patients with cirrhosis

Muhsen

AlFreihi

Abaalkhail

et al. 2018

Saudi J Gastroenterol

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Background/Aims:Evidence of increased risk of osteoporosis and osteopenia in chronic liver disease and cirrhosis is inconsistent. This study aims to investigate this relationship and to identify the predictors of increased loss of bone mineral density in Saudi patients.Patients and Methods:One hundred and sixty-four patients and controls who are age and gender matched, were included in this study with 1:1 ratio. Patients' included in this study were adults with confirmed liver cirrhosis. Bone mineral densitometry (BMD) at both lumbar spine (LS) and femoral neck (FN) were collected for both groups. Univariate and multivariate regression analyses were performed to identify predictors of BMD loss.Results:Results showed that cirrhotic patients are at higher risk of developing osteoporosis or osteopenia at LS (OR 2.23, 95% CI [1.19–4.19], P = 0.01) but not at FN, when compared to control sample. Patients with cirrhosis were found to have lower vitamin D and PTH levels (P = 0.0005) and (P = 0.006), respectively. Of the possible predictors tested (gender, age, body mass index [BMI], phosphorus, calcium, parathyroid hormone (PTH), vitamin D, and Model for End Stage Liver Disease [MELD] score), female gender was the main predictor of loss of BMD at LS only (OR 4.80, 95% CI [1.47–15.73], P = 0.01).Conclusions:The study showed that cirrhotic patients are at increased susceptibility of having decreased BMD, particularly at the LS and it highlights the need for preventive measures, especially for female patients.

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“…Reduced bone mineral density (BMD) caused by both decreased physiological bone turnover and limited osteosynthesis processes is one of the most common extrahepatic complications found in adults suffering from end-stage liver disease ( 1 ). In addition, most patients suffering from liver disease also have multiple risk factors for osteodystrophy, including protein-calorie malnutrition and vitamin D deficiency ( 2 ). Hepatic osteodystrophy (HOD), a term for bone loss and fractures caused by liver disease ( 3 ), occurs in up to 50% of patients undergoing chronic liver disease (CLD) ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

The roles of hepatokine and osteokine in liver-bone crosstalk: Advance in basic and clinical aspects

et al. 2023

Front. Endocrinol.

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Both the liver and bone are important secretory organs in the endocrine system. By secreting organ factors (hepatokines), the liver regulates the activity of other organs. Similarly, bone-derived factors, osteokines, are created during bone metabolism and act in an endocrine manner. Generally, the dysregulation of hepatokines is frequently accompanied by changes in bone mass, and osteokines can also disrupt liver metabolism. The crosstalk between the liver and bone, particularly the function and mechanism of hepatokines and osteokines, has increasingly gained notoriety as a topic of interest in recent years. Here, based on preclinical and clinical evidence, we summarize the potential roles of hepatokines and osteokines in liver-bone interaction, discuss the current shortcomings and contradictions, and make recommendations for future research.

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Risk factors for osteoporosis in patients with end-stage liver disease

Cited by 7 publications

References 20 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

Bone mineral density loss in patients with cirrhosis

The roles of hepatokine and osteokine in liver-bone crosstalk: Advance in basic and clinical aspects

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