title: Osteoporosis, mineral metabolism, and serum soluble tumor necrosis factor receptor p55 in viral cirrhosis.
abstract: Liver cirrhosis is a risk factor for osteoporosis. Nevertheless, little is known about the mechanisms of bone mass loss in patients with viral cirrhosis. TNFalpha is a potent bone-resorbing agent. Serum concentrations of soluble TNF receptor p55 (sTNFR-55) correlate with clinical activity in liver cirrhosis. Our aim was to evaluate the possible role of sTNFR-55 in the pathogenesis of osteoporosis in patients with viral cirrhosis and its relationship with bone turnover markers. We studied 40 consecutive patients with viral cirrhosis and no history of alcohol intake and 26 healthy volunteers. Bone mineral density (BMD) was measured by dual x-ray absorptiometry in the lumbar spine (LS) and femoral neck (FN). Patients with viral cirrhosis had reduced BMD (expressed as the z-score) in all sites [LS, -1.5 +/- 0.22 (P < 0.001); FN, -0.37 +/- 0.15 (P < 0.01)]. Serum concentrations of sTNFR-55 and urinary deoxypyridinoline, a biochemical marker of bone resorption, were significantly higher in patients with osteoporosis than in patients without osteoporosis (P < 0.001 and P < 0.05, respectively). Serum levels of sTNFR-55 correlated inversely with BMD in LS (r = -0.62; P < 0.005) and FN (r = -0.47; P < 0.05) and positively with urinary deoxypyridinoline (r = 0.72, P < 0.001). Our findings show that high serum concentrations of sTNFR-55 play a role in the pathogenesis of viral cirrhosis-associated bone mass loss and provide evidence of increased bone resorption related to the high serum sTNFR-55 levels.
authors.affiliation: Department of Gastroenterology, University Hospital San Cecilio, 18012 Granada, Spain. jorgegonzalezc@meditex.es
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Gonzalez-Calvin
authors.forename: Francisco
authors.initials: F
authors.lastname: Gallego-Rojo
authors.forename: Ramon
authors.initials: R
authors.lastname: Fernandez-Perez
authors.forename: Francisco
authors.initials: F
authors.lastname: Casado-Caballero
authors.forename: Elena
authors.initials: E
authors.lastname: Ruiz-Escolano
authors.forename: Enrique G
authors.initials: EG
authors.lastname: Olivares
mesh_terms: D000328:Adult; D000368:Aged; D015519:Bone Density; D001842:Bone and Bones / Q000378:metabolism; D002112:Calcifediol / Q000097:blood; D002352:Carrier Proteins / Q000097:blood*; D006509:Hepatitis B / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008103:Liver Cirrhosis / Q000150:complications* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology*; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood*; D047888:Receptors, Tumor Necrosis Factor, Type I; D012044:Regression Analysis; D053319:Tumor Necrosis Factor Decoy Receptors
chemical_list: D002352:Carrier Proteins; D018124:Receptors, Tumor Necrosis Factor; D047888:Receptors, Tumor Necrosis Factor, Type I; D053319:Tumor Necrosis Factor Decoy Receptors; C069521:recombinant human tumor necrosis factor-binding protein-1; D007334:Insulin-Like Growth Factor I; D002112:Calcifediol