Background Loss of bone mass is frequently identified in cirrhosis, leading to fragility fractures and significant morbidity. The pathogenesis is not completely elucidated.
Objectives The aim of this study is to assess the prevalence of bone loss in cirrhotic patients and identify risk factors.
Methods Bone mineral density (BMD) was performed in patients with cirrhosis seen in our department in 2011, by X-ray absorptiometry (DEXA) at both lumbar spine and femoral neck sites. Other diseases disturbing the bone density were excluded. Osteopenia was considered if T score < -1.5 DS and osteoporosis if T-score <-2.5 DS. We collected clinical data including risk factors for bone mass loss and nutritional status.
Results Fifty patients with cirrhosis were included. They were 28 males and 22 females with a mean age of 54 years (17-84). Aetiology of cirrhosis was viral in 48% and auto-immune in 20%. Child-Pugh score was C in 32% and mean Meld score was 14 (5-32). BMD disclosed osteopenia in 32% and osteoporosis in 32%. Mean bone mass and T score were 0.94 kg/m2 and -0.67 DS in femoral neck; 0.98 kg/m2 and -1.2 DS in lumbar spine. History of fracture was present in 10% of cases. Low bone mass was correlated with female sex (p=0.01), age (p=0.04), sedentary (p=0.01) and Child Pugh C (p=0.03) but not with nutritional status.
Conclusions In our study, prevalence of osteoporosis was 32%, as reported in Occident. Advanced liver disease in association with classical risk factors of osteoporosis was correlated with BMD. This high prevalence suggests that bone status should be evaluated routinely in patients with cirrhosis.
Disclosure of Interest None Declared
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