title: Bone mineral density, bone turnover markers and cytokines in alcohol-induced cirrhosis.
abstract: OBJECTIVE
  Liver cirrhosis is a risk factor for osteoporosis. However, the pathogenesis of the bone mass loss in patients with alcohol-induced cirrhosis (AC) is not well understood. Serum concentrations of soluble tumour necrosis factor receptor (sTNF-R55), neopterin and soluble interleukin 2 receptor (sIL-2R), activation markers of cellular immunity, correlate with clinical activity and severity of the AC. The aim of this study is to evaluate the association of these soluble markers with the development of osteoporosis in patients with AC.
  
  
  METHODS
  We studied 33 consecutive patients with AC and 24 healthy volunteers. Bone mineral density (BMD) was measured by X-ray absorptiometry in the lumbar spine (LS) and femoral neck (FN). Neopterin was measured by radioimmunoassay. Serum concentrations of sTNF-R55 and sIL-2R were measured by enzyme immunoassay. We also determined serum levels of osteocalcin and bone alkaline phosphatase as biochemical markers of bone formation, and deoxypyridinoline urinary excretion (D-Pyr) as marker of bone resorption.
  
  
  RESULTS
  Patients with AC had reduced BMD (expressed as z-score) in all sites (LS: P < 0.001 and FN: P < 0.05). Serum concentrations of sTNF-R55 were significantly higher in patients with both AC and osteoporosis than in those with only AC (P < 0.001). Serum levels of sTNF-R55 positively correlated with D-Pyr urinary excretion (r = 0.354; P = 0.01). Serum levels of sIL-2R were significantly higher in patients with both AC and osteoporosis than in those with only AC (P < 0.05).
  
  
  CONCLUSIONS
  There is a relation between activation of the cellular immunity and osteoporosis in AC. Bone mass loss could be related to the increased bone resorption found in these patients.
authors.affiliation: Department of Internal Medicine, University of Granada, Granada, Spain. adiez@ugr.es
authors.forename: Antonio
authors.initials: A
authors.lastname: Díez-Ruiz
authors.forename: Pedro L
authors.initials: PL
authors.lastname: García-Saura
authors.forename: Pablo
authors.initials: P
authors.lastname: García-Ruiz
authors.forename: Jorge L
authors.initials: JL
authors.lastname: González-Calvin
authors.forename: Francisco
authors.initials: F
authors.lastname: Gallego-Rojo
authors.forename: Dietmar
authors.initials: D
authors.lastname: Fuchs
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D015519:Bone Density / Q000502:physiology*; D016207:Cytokines / Q000378:metabolism*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010012:Osteogenesis / Q000502:physiology*; D010024:Osteoporosis / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D016207:Cytokines