Reduction of volumetric bone mineral density in postmenopausal women with hepatitis C virus-correlated chronic liver disease: a peripheral quantitative computed tomography (pQCT) study.
BACKGROUND
The prevalence of osteoporosis in chronic liver disease (CLD) varies considerably among the studies, depending on patient selection and diagnostic criteria. We aimed to measure bone turnover markers and volumetric bone mineral density (BMD) in a group of postmenopausal women with CLD using both dual energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT), in comparison with age-matched healthy subjects.


METHODS
Thirty-five postmenopausal patients with HCV-correlated CLD and 35 healthy postmenopausal women, as controls, underwent a DXA scan at lumbar and femoral level and a pQCT measurement of the nondominant forearm. Serum concentrations of biochemical markers relevant to bone turnover were also measured.


RESULTS
Patients showed no differences in DXA values either at lumbar or femoral level compared to controls. On the contrary, pQCT geometrical (cortical cross-sectional area) and volumetric (total and trabecular volumetric BMD) parameters were significantly reduced in the CLD women. Also the Strength-Strain Index (SSI), an estimate of diaphyseal bone resistance to bending and torsion, was significantly lower in patients than in controls. Patients with CLD presented an unbalanced bone turnover, with increased bone resorption markers.


CONCLUSIONS
The bone geometrical and volumetric parameters measured in our CLD postmenopausal women, by pQCT, show a reduced bone mineral quality and stiffness. Conversely, DXA-measurements seem unable to appreciate the bone alterations in these patients. This would encourage further studies to validate pQCT analysis as a diagnostic tool for a correct estimate of bone involvement in CLD.
Department of Internal Medicine, University of Catania, Via Plebiscito 628, 95124 Catania Italy.
Agostino
A
Gaudio
Piera
P
Pennisi
Francesco
F
Muratore
Gaetano
G
Bertino
Annalisa
A
Ardiri
Ivana
I
Pulvirenti
Giovanni
G
Tringali
Carmelo Erio
CE
Fiore
D015502:Absorptiometry, Photon; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000209:etiology; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging*; D017698:Postmenopause; D014057:Tomography, X-Ray Computed
D015415:Biomarkers