Background Bone manifestations are well-known extra hepatic complication of chronic liver disease. The prevalence of osteoporosis among patients with chronic liver diseases ranges from 10% to 60%.
Objectives the aim of this study was to assess the prevalence and risk factors of osteoporosis in patients with chronic liver disease.
Methods The study was carried out in 60 patients with viral hepatitis B, C and primary biliary cirrhosis (PCB).Bone mineral density (BMD, g/cm) was assessed by dual X-ray absorptiometry.
Osteoporosis was diagnosed when BMD was 2.5 standard deviations below the mean peak value in young adults (T score, 22.5 SD).
Patients with other pathology that may change the bone metabolism were excluded.
Results Sixty patients (29 women and 31 men) were included in our study, with a mean age of 51.2 years (19-82 years). Thirteen patients had PBC (21.7%), thirteen suffering from hepatitis C (21.7%) and thirty four had hepatitis B (56.7%). Cirrhosis was found in 36.7% of patients (Child A: n=6, child B: n=10, Child C: n=6). No patient was taking calcium supplements, six of them had a history of fractures, and only four had a family history of osteoporosis. Eighteen patients had osteoporosis (30%), eighteen had osteopenia (30%) and 24 patients had normal bone density. Osteoporosis was found in 27% of patients with hepatitis B, 30% of patients with hepatitis C and in 70% of patients with PBC. The bone loss was associated with advanced age (54.5±12, 87 VS 46.2±16 years, p=0.03), with a low body mass index (23.6±4,7 vs 26,67±6 kg/m 2, p=0.0038) and with a low albumin levels (33.6±6 vs 38.2±5.36 g/l, p=0.004). It was also significantly associated with the presence of esophageal varices (p=0.02) and PBC (p=0.04).
Conclusions Osteoporosis is effectively a complication of chronic liver disease. Cholestasis in addition to advanced age, low body mass index, low albumin level and the presence of esophageal varices are risk factors of osteoporosis in chronic liver disease.
Disclosure of Interest None Declared
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