Turkish Journal of Gastroenterology, vol.9, no.2, pp.95-100, 1998 (SCI-Expanded)
Osteoporosis is a multifactorial systemic skeletal disease characterized by increased bone fragility due to a decrease in bone mineral density (BMD). It arises as a primary or secondary disease and chronic liver disease is one of the various etiologies that cause secondary osteoporosis. In this study, we investigated the incidence of osteoporosis and the status of bone metabolism in cirrhotic diseases of variable etiology. We studied 50 cirrhotic patients (24 males, 26 females, mean age: 50 ± 13) diagnosed both clinically and histopathologically and 50 healthy control subjects, showing similar age and sex characteristics (24 males, 26 females, mean age: 50 ± 13). The presence of osteoporosis was evaluated with measurements of cortical and trabecular BMD by computerized tomography. The association between these measurements and the etiology, duration and Child classification of the liver cirrhosis was investigated. In addition, bone alkaline phosphatase, parathormone, calcium and hydroxypyroline levels in 24 hour urine collections were studied as indicators of bone metabolism. Cortical and trabecular BMDs were significantly reduced in cirrhotic patients compared to control group both in male and female patients (p<0.0001; p<0.05 respectively). However, the difference of cortical and trabecular BMD values in cirrhotic patients due to alcohol and in those with viral etiology was insignificant (p>0.05;p>0.05 respectively). No association was found between duration of disease (less or more than 3 years) and Child staging with BMD (cortical or trabecular) values. The bone metabolism indicators such as parathormone, 24 hour urine calcium and hydroxypyroline levels in cirrhotic patients was found to be significantly different than control group (p<0.001; p<0.005; p<0.0001 respectively). However, bone alkaline phosphatase levels were not significantly different (p>0.05). Although cortical and trabecular BMD was significantly lower in cirrhotic patients than that of the control group, we concluded that it did not correlate with the duration, etiology and Child classification of the disease.