Low bone mineral density in noncholestatic liver cirrhosis: prevalence, severity and prediction.
BACKGROUND
Metabolic bone disease has long been associated with cholestatic disorders. However, data in noncholestatic cirrhosis are relatively scant.


OBJECTIVE
To determine prevalence and severity of low bone mineral density in noncholestatic cirrhosis and to investigate whether age, gender, etiology, severity of underlying liver disease, and/or laboratory tests are predictive of the diagnosis.


METHODS
Between March and September/1998, 89 patients with noncholestatic cirrhosis and 20 healthy controls were enrolled in a cross-sectional study. All subjects underwent standard laboratory tests and bone densitometry at lumbar spine and femoral neck by dual X-ray absorptiometry.


RESULTS
Bone mass was significantly reduced at both sites in patients compared to controls. The prevalence of low bone mineral density in noncholestatic cirrhosis, defined by the World Health Organization criteria, was 78% at lumbar spine and 71% at femoral neck. Bone density significantly decreased with age at both sites, especially in patients older than 50 years. Bone density was significantly lower in post-menopausal women patients compared to pre-menopausal and men at both sites. There was no significant difference in bone mineral density among noncholestatic etiologies. Lumbar spine bone density significantly decreased with the progression of liver dysfunction. No biochemical variable was significantly associated with low bone mineral density.


CONCLUSIONS
Low bone mineral density is highly prevalent in patients with noncholestatic cirrhosis. Older patients, post-menopausal women and patients with severe hepatic dysfunction experienced more advanced bone disease. The laboratory tests routinely determined in patients with liver disease did not reliably predict low bone mineral density.
Figueiredo
Fátima Aparecida Ferreira
FA
Department of Internal Medicine, University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil. faff@gbl.com.br
Brandão
Cynthia
C
Perez
Renata de Mello
Rde M
Barbosa
Walnei Fernandes
WF
Kondo
Mario
M
D000328:Adult; D000367:Age Factors; D000368:Aged; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012737:Sex Factors