[Changes in bone mass in hepatic cirrhosis, chronic obstructive pulmonary disease, insulin-dependent diabetes, and primary hyperparathyroidism].
BACKGROUND
Liver cirrhosis, chronic obstructive pulmonary disease (COPD), insulin-dependent diabetes mellitus and primary hyperparathyroidism are frequent diseases which are considered as risk factors for the development of osteoporosis. However, review of the literature has shown that the studies published on the aforementioned are far from conclusive.


METHODS
By double energy X-ray absorptiometry the bone mineral density (BMD) of the lumbar spine and neck of the femur were determined in 29 patients with liver cirrhosis, 92 with chronic obstructive pulmonary disease (59 treated with corticoids), 81 with insulin-dependent diabetes mellitus and 30 primary hyperparathyroidism (7 operated).


RESULTS
Cirrhotic patients had a normal BMD in both localizations. In patients with COPD, without corticoids, a decrease of 6% was found in the spine and or 13.5% in the neck of the femur while in patients with COPD with corticoids the decrease was of 12% and 7% respectively. Diabetic patients had normal BMD in the spine and a decrease of 6% in the neck of the femur and in patients with hyperparathyroidism a decrease of 6% and normality were found, respectively.


CONCLUSIONS
The repercussion of cirrhosis, insulin-dependent diabetes, and primary hyperparathyroidism on bone mineral density is nul or slight. In patients with chronic obstructive pulmonary disease treated with corticoids decrease in density of the spine is approximately that of a standard deviation. In patients with the latter not treated with corticoids a similar decrease is found in the neck of the femur.
Departamento de Medicina Interna, Hospital Marqués de Valdecilla, Universidad de Cantabria, Santander.
J
J
Napal
Y
Y
Cuerno
J M
JM
Olmos
J A
JA
Riancho
J A
JA
Amado
J
J
González Macías
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism*; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000378:metabolism*; D008103:Liver Cirrhosis / Q000378:metabolism*; D008173:Lung Diseases, Obstructive / Q000378:metabolism*; D008297:Male; D008875:Middle Aged
Modificaciones de la masa ósea en la cirrosis hepática, la enfermedad pulmonar obstructiva crónica, la diabetes dependiente de la insulina y el hiperparatiroidismo primario.