Loading ...
Sorry, an error occurred while loading the content.

8781Bone Loss in Liver Disease: hepatic osteodystrophy

Expand Messages
  • claudine intexas
    Feb 5, 2002
      NATAP - www.natap.org

      Bone Loss in Liver Disease: hepatic osteodystrophy

      This interesting article discusses the risk factors associated with
      bone loss in persons with liver disease. The authors suggest
      advancing liver disease is associated with bone loss so improved
      disease progression may improve bone loss. Additional risk factors
      include hyperbilirubinema, chronic alcohol use, tobacco use, a
      decline in circulating estrogen, hypogonadism is an established risk
      factor for osteoporosis (chronic liver disese accelerates
      hypogonadism and a reduction in serum testosterone develops),
      corticosteroid therapy, lack of weight bearing exercise, and diet and
      vitamin intake deficiencies. The reported prevalence of osteoporosis
      among patients with chronic liver disease ranges from 20% to 100%,
      depending on patient selection and diagnostic criteria. The authors
      of this article report that the cause is unclear and likely to be
      multifactorial. The article discusses various theories as to the
      cause. Regardless of the cause of bone disease in these patients,
      they have an increase in bone pain & fractures, and this is a major
      source of morbidity preceding and following liver transplanation.


      At AASLD (Nov 2001), investigators reported the prevalence of bone
      disease in adults with end stage liver disease. 120 adult patients
      with chronic end stage liver disease were evaluated (44 females and
      76 males). Osteoporosis was found in 47 patients (39%), osteopenia
      in 42 patients (35%) and normal bone mineral density in 31 patients
      (26%). Investigators reported that in this study, on multivariate
      analysis, cause from virus was found to be a strong predictor of bone
      disease. Patients with viral liver disease are 5.4 times more likely
      to have bone disease when compared to those with non-viral liver
      disease (p=0.04).

      In HIV, patients appear to be experienced increased rates of
      osteopenia and osteonecrosis. Doctors to develop strategies to
      address the patient coinfected with HIV and HCV since they may be
      exposed to greater risks for bone disorders. Researchers should
      prioritize this problem and develop research studies to explore these
      problems and better understand the questions and prevalence, and
      potential interventions.

      Osteopenia in HIV Infection, written by Andrew Carr, MD

      Osteonecrosis (avascular necrosis) in HIV

      Do You Yahoo!?
      Send FREE Valentine eCards with Yahoo! Greetings!