title: Reduced bone mineral density and altered bone turnover markers in patients with non-cirrhotic chronic hepatitis B or C infection.
abstract: OBJECTIVE
  Previous studies suggest that loss of bone mineral density (BMD) frequently occurs in patients with chronic viral liver disease, presenting with histologically proven liver cirrhosis. However, little is known about the occurrence of bone disease in non-cirrhotic patients with chronic hepatitis B or C. Therefore, it was the aim of this study to evaluate this particular population for BMD and bone turnover markers.
  
  
  METHODS
  Biochemical markers of bone turnover and BMD were measured in 43 consecutive patients with HCV (n = 30) or HBV (n = 13) infection without histological evidence for liver cirrhosis. Mean age was 49 years (range 26-77 years). BMD was measured by dual X-ray absorptiometry in the femoral neck (FN) and the lumbar spine (LS) region. In addition, bone metabolism markers were measured.
  
  
  RESULTS
  BMD was lowered in 25 (58%) of the patients with chronic hepatitis B or C (FN: 0.76 (0.53-0.99); LS: 0.96 (0.62-1.23) g/cm(2)). Eight (32%) osteopenic patients were diagnosed with osteoporosis. Bone-specific alkaline phosphatase (P = 0.005) and intact parathyroid hormone (iPTH) (P = 0.001) were significantly elevated in the more advanced stages of fibrosis. Mean T-score value was lower in patients with chronic hepatitis C as compared to patients suffering from chronic hepatitis B; however, the difference was not statistically significant (P = 0.09).
  
  
  CONCLUSIONS
  There was a significantly reduced BMD in non-cirrhotic patients with chronic hepatitis B or C infection. Alterations of bone metabolism already occurred in advanced liver fibrosis without cirrhosis. According to our results, these secondary effects of chronic viral hepatitis should be further investigated.
authors.affiliation: Department of Medicine II, University of Leipzig, Philipp-Rosenthal Str. 27, 04103 Leipzig, Germany. schi@medizin.uni-leipzig.de
authors.forename: Ingolf
authors.initials: I
authors.lastname: Schiefke
authors.forename: Andreas
authors.initials: A
authors.lastname: Fach
authors.forename: Marcus
authors.initials: M
authors.lastname: Wiedmann
authors.forename: Andreas-V
authors.initials: AV
authors.lastname: Aretin
authors.forename: Eva
authors.initials: E
authors.lastname: Schenker
authors.forename: Gudrun
authors.initials: G
authors.lastname: Borte
authors.forename: Manfred
authors.initials: M
authors.lastname: Wiese
authors.forename: Joachim
authors.initials: J
authors.lastname: Moessner
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D015519:Bone Density; D001842:Bone and Bones / Q000378:metabolism*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications / Q000378:metabolism*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000378:metabolism*; D006801:Humans; D008103:Liver Cirrhosis; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000378:metabolism* / Q000473:pathology
chemical_list: D015415:Biomarkers