Effects of chronic liver disease on bone mineral density and bone metabolism markers in postmenopausal women.
OBJECTIVE
Patients with chronic liver disease (CLD) have an increased prevalence of osteoporosis. However, there is limited information about the effects of end-stage liver disease on bone metabolism and bone mineral density values in postmenopausal women. The aim of this study was to investigate the effects of chronic liver disease on bone mineral density (BMD) and bone metabolism markers in postmenopausal women.


METHODS
We studied BMD by using dual-energy X-ray absorptiometry (DEXA), biochemical markers of bone turnover and calcium-parathyroid hormone (PTH)-Vitamin D axis in 22 postmenopausal women with CLD. Control group consisted of randomly recruited 30 healthy postmenopausal women.


RESULTS
Based on WHO criteria, the prevalence of osteoporosis was significantly higher in patients with CLD (72 versus 33%) compared to healthy postmenopausal women. Bone loss was more significant at the lumbar spine than femur in the study group. Urinary excretion of bone resorption marker deoxypyridinoline was increased significantly in patients with CLD. There were no significant differences in bone formation markers (osteocalcin and bone alkaline phosphatase) between the groups.


CONCLUSIONS
CLD increases the prevalence of osteoporosis in postmenopausal women, particularly in the lumbar spine. Increased bone resorption seems to be the main reason for osteoporosis in these patients. We suggest that treatment strategies should be improved in these women to protect them from subsequent fractures.
Uretmen
Sevinc
S
Izmir Ataturk Research and Training Hospital, Department of Internal Medicine, Turkey.
Gol
Mert
M
Cimrin
Dilek
D
Irmak
Esra
E
D000469:Alkaline Phosphatase / Q000097:blood / Q000378:metabolism; D000596:Amino Acids / Q000378:metabolism / Q000652:urine; D001663:Bilirubin / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism*; D015519:Bone Density / Q000502:physiology*; D016723:Bone Remodeling / Q000502:physiology; D001842:Bone and Bones / Q000378:metabolism*; D002118:Calcium / Q000378:metabolism; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D005269:Femur / Q000033:anatomy & histology / Q000502:physiology; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000378:metabolism*; D008159:Lumbar Vertebrae / Q000033:anatomy & histology / Q000502:physiology; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood / Q000378:metabolism; D015663:Osteoporosis, Postmenopausal / Q000209:etiology / Q000378:metabolism; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000378:metabolism; D017698:Postmenopause / Q000502:physiology*
D000596:Amino Acids; D015415:Biomarkers; D010281:Parathyroid Hormone; D015675:Osteocalcin; D010758:Phosphorus; C036020:deoxypyridinoline; D000469:Alkaline Phosphatase; D001663:Bilirubin; D002118:Calcium