Background Metabolic bone disease is common among patients with chronic liver disease. It is known as hepatic osteodystrophy. Osteoporosis is the most common complication; its incidence varies between 20 and 100% depending on the series.
Objectives the aim of this study was to assess the prevalence and risk factors of hepatic osteodystrophy in patients with chronic viral hepatitis.
Methods The study was carried out in 47 patients with chronic viral hepatitis B or C. 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 This is a prospective study including 47 patients (16 women and 31 men), with a mean age of 49.8 years (19-80 years). Thirteen patients had hepatitis C (28%) and thirty four were carriers of hepatitis B (72%). Liver cirrhosis was found in 38, 3% of patients (Child A: n=5, Child B: n=8, child C: n=5). No patient was taking calcium supplements, four of them had a history of fractures, and only three had a family history of osteoporosis. Almost a third of our patients were smokers and 10% of them were alcohol drinkers. Among patients with hepatitis C, 4 had osteoporosis and 3 had osteopenia. For those with hepatitis B, five had osteoporosis and 13 osteopenia. Osteoporosis was associated with female sex (p=0.022). Patients with bone loss had respectively a body mass index and albumin levels lower than patients with normal bone density 26.3 vs 23 kg/m2; p=0.05 and 38.2 VS 33.2 g/l; p=0.03 respectively. There were no significant differences between the two groups regarding the nature of hepatitis, disease duration, sex, cytolysis, cholestasis and cirrhosis.
Conclusions Bone loss must be systematically sought in chronic viral hepatitis. Female sex, low body mass index and low albumin level are risk factors of hepatic osteodystrophy in patients with viral hepatitis.
Disclosure of Interest None Declared