title: Assessing bone status in patients awaiting liver transplantation.
abstract: Osteoporosis is common in liver transplant recipients as a result of both iatrogenic factors and preexisting hepatic osteodystrophy.
  
  
  OBJECTIVE
  To assess the prevalences of osteoporosis and fractures and to identify risk factors for these two abnormalities in patients awaiting liver transplantation for end-stage liver disease.
  
  
  METHODS
  Between January 2006 and December 2007, patients on a liver transplant waiting list underwent a routine evaluation comprising the identification of risk factors for osteoporosis, radiographs of the spine, bone mineral density measurements (BMD), and laboratory tests (phosphate and calcium levels, hormone assays, liver function tests, and bone turnover markers).
  
  
  RESULTS
  We studied 99 patients (70 males and 20 females; mean age, 55 ± 8 years) including 75% with alcohol-induced cirrhosis with or without hepatocarcinoma. Among them, 36% had radiographic vertebral fractures, 38% had osteoporosis, 35% had osteopenia, and 88% had vitamin D insufficiency or deficiency (25(OH)vitamin D3<20 ng/mL). Lower BMD values were associated with vertebral fractures; the odds ratios and 95% confidence intervals for each BMD decrease of 1 SD were as follows: spine, 1.45 (95%CI, 1.1-1.9); total hip, 2.1 (95%CI, 1.3-3.2); and femoral neck, 2 (95%CI, 1.3-3.1) (P<0.05). Levels of bone resorption markers correlated negatively with BMD at the spine and hip. The Model for End-Stage Liver Disease score correlated negatively with hip BMD.
  
  
  CONCLUSIONS
  Our findings suggest high prevalences of low BMD values and vertebral fractures among patients awaiting liver transplantation. Bone status should be evaluated routinely in candidates to liver transplantation.
authors.affiliation: Service de rhumatologie, département universitaire de rhumatologie, université Nord de France, hôpital Roger-Salengro, CHRU de Lille, Lille, France. Cecile.WIBAUX@CHRU-LILLE.FR
authors.forename: Cécile
authors.initials: C
authors.lastname: Wibaux
authors.forename: Isabelle
authors.initials: I
authors.lastname: Legroux-Gerot
authors.forename: Sébastien
authors.initials: S
authors.lastname: Dharancy
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Boleslawski
authors.forename: Nicole
authors.initials: N
authors.lastname: Declerck
authors.forename: Valérie
authors.initials: V
authors.lastname: Canva
authors.forename: Philippe
authors.initials: P
authors.lastname: Mathurin
authors.forename: François-René
authors.initials: FR
authors.lastname: Pruvot
authors.forename: Bernard
authors.initials: B
authors.lastname: Cortet
mesh_terms: D015502:Absorptiometry, Photon; D015519:Bone Density; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000378:metabolism*; D019963:Clinical Chemistry Tests; D003430:Cross-Sectional Studies; D058625:End Stage Liver Disease / Q000150:complications* / Q000378:metabolism / Q000601:surgery; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications* / Q000175:diagnosis* / Q000378:metabolism; D011446:Prospective Studies; D012307:Risk Factors; D014850:Waiting Lists