title: Hepatic osteodystrophy is common in patients with noncholestatic liver disease.
abstract: BACKGROUND
  Patients with cirrhosis are more prone to develop metabolic bone disease. Scanty literature data are available on osteodystrophy in patients from India with noncholestatic liver diseases.
  
  
  METHODS
  Patients diagnosed with cirrhosis were prospectively evaluated for bone mineral density (BMD) as measured by dual-energy X-ray absorptiometry at the femoral neck, lumbar spine, and left forearm (distal radius). Correlation of BMD with age, sex, etiology of cirrhosis, Child's class, serum bilirubin, alkaline phosphatase (ALP), albumin, calcium, phosphate, 25-hydroxyvitamin D (25(OH)D), and parathyroid hormone (PTH) was studied.
  
  
  RESULTS
  The study group comprised 115 cirrhotic patients (107 males and 8 females). Etiology of cirrhosis was alcohol in 67 (58.2%) and viral in 48 (41.7%). Hepatitis B was diagnosed in 29 (25.2%) and hepatitis C in 19 (16.5%). Mean age was 49 (± 5.5) years. Prevalence of osteodystrophy was significantly higher in males than in females; 97.1% and 75% respectively (P = .038). Both alcoholic and viral groups had similar baseline characteristics except albumin levels. Child's class was B in 72 patients and C in 43. Low BMD was present in 97% of patients with alcoholic cirrhosis and 93.7% with viral cirrhosis (P > .05). Low BMD was present at the femoral neck in 80.8% of patients, lumbar spine in 77.3%, and forearm in 59.9%. PTH correlated negatively with BMD.
  
  
  CONCLUSIONS
  Osteodystrophy is common in alcoholic and viral cirrhosis patients.
authors.affiliation: Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: N S
authors.initials: NS
authors.lastname: Choudhary
authors.forename: M
authors.initials: M
authors.lastname: Tomar
authors.forename: Y K
authors.initials: YK
authors.lastname: Chawla
authors.forename: S K
authors.initials: SK
authors.lastname: Bhadada
authors.forename: N
authors.initials: N
authors.lastname: Khandelwal
authors.forename: R K
authors.initials: RK
authors.lastname: Dhiman
authors.forename: A
authors.initials: A
authors.lastname: Duseja
authors.forename: A
authors.initials: A
authors.lastname: Bhansali
mesh_terms: D000328:Adult; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D015995:Prevalence; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D