title: Bone mineral density and serum levels of soluble tumor necrosis factors, estradiol, and osteoprotegerin in postmenopausal women with cirrhosis after viral hepatitis.
abstract: BACKGROUND
  Cirrhosis after viral hepatitis has been identified as a risk factor for osteoporosis in men. However, in postmenopausal women, most studies have evaluated the effect of primary biliary cirrhosis, but little is known about the effect of viral cirrhosis on bone mass [bone mineral density (BMD)] and bone metabolism.
  
  
  OBJECTIVE
  Our objective was to assess the effect of viral cirrhosis on BMD and bone metabolism in postmenopausal women.
  
  
  METHODS
  We conducted a cross-sectional descriptive study.
  
  
  METHODS
  We studied 84 postmenopausal female outpatients with viral cirrhosis and 96 healthy postmenopausal women from the general community. BMD was measured by dual-energy x-ray absorptiometry at lumbar spine (LS) and femoral neck (FN).
  
  
  RESULTS
  The percentage with osteoporosis did not significantly differ between patients (LS, 43.1%; FN, 32.2%) and controls (LS, 41.2%; FN, 29.4%), and there was no difference in BMD (z-score) between groups. Serum concentrations of soluble TNF receptors, estradiol, and osteoprotegerin (OPG) were significantly higher in patients vs. controls (P < 0.001, P < 0.05, and P < 0.05, respectively). No significant difference was observed in urinary deoxypyridinoline. Serum OPG levels were positively correlated with soluble TNF receptors (r = 0.35; P < 0.02) and deoxypyridinoline (r = 0.37; P < 0.05).
  
  
  CONCLUSIONS
  This study shows that bone mass and bone resorption rates do not differ between postmenopausal women with viral cirrhosis and healthy postmenopausal controls and suggests that viral cirrhosis does not appear to increase the risk of osteoporosis in these women. High serum estradiol and OPG concentrations may contribute to preventing the bone loss associated with viral cirrhosis in postmenopausal women.
authors.affiliation: Department of Gastroenterology, University Hospital San Cecilio, Granada, Spain. jgcalvin@ugr.es
authors.forename: Jorge L
authors.initials: JL
authors.lastname: González-Calvin
authors.forename: Jose L
authors.initials: JL
authors.lastname: Mundi
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Casado-Caballero
authors.forename: Ana C
authors.initials: AC
authors.lastname: Abadia
authors.forename: Jose J
authors.initials: JJ
authors.lastname: Martin-Ibañez
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000097:blood; D015519:Bone Density / Q000502:physiology*; D001842:Bone and Bones / Q000378:metabolism; D003430:Cross-Sectional Studies; D004958:Estradiol / Q000097:blood*; D005260:Female; D006525:Hepatitis, Viral, Human / Q000097:blood* / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000209:etiology*; D008875:Middle Aged; D053244:Osteoprotegerin / Q000097:blood*; D017698:Postmenopause / Q000097:blood*; D053246:Receptor Activator of Nuclear Factor-kappa B / Q000097:blood / Q000235:genetics; D018124:Receptors, Tumor Necrosis Factor / Q000378:metabolism; D012307:Risk Factors; D048069:Tumor Necrosis Factors / Q000097:blood*
chemical_list: D000596:Amino Acids; D053244:Osteoprotegerin; D053246:Receptor Activator of Nuclear Factor-kappa B; D018124:Receptors, Tumor Necrosis Factor; D048069:Tumor Necrosis Factors; D004958:Estradiol; C036020:deoxypyridinoline