title: Bone alterations in hepatitis C virus infected patients.
abstract: OBJECTIVE
  Most studies have shown that patients with chronic hepatitis C virus (HCV) infection are affected by osteoporosis. However, liver function impairment and deranged nutrition may both play a role in the bone alterations observed. In some works no osteoporosis was found, and some cases of osteosclerosis have been reported. The aim of the study is to assess bone alterations in treatment-naïve, well-nourished HCV patients, in order to discern whether or not HCV infection causes osteoporosis.
  
  
  METHODS
  Whole-body bone densitometry and assessment of T-score at lumbar spine and hip were performed to 40 patients and 40 age- and sex-matched controls, with a Lunar Prodigy Advance (General Electric, Piscataway, NJ, USA). All the patients underwent liver biopsy. Nutritional evaluation was performed by subjective nutritional assessment, body mass index (BMI), and densitometric assessment of total lean mass and total fat mass. Serum osteocalcin, osteoprotegerin, RANKL, PTH, crosslaps, vitamin D3, testosterone, IGF-1, and estradiol were determined.
  
  
  RESULTS
  Patients did not show differences in total bone mineral density (BMD) or T-score with controls. On the contrary, about a third of them showed positive T scores. Patients showed lower IGF-1, vitamin D3 and testosterone, but higher telopeptide levels, and a trend to higher osteoprotegerin levels. Multivariate analyses disclosed that age, sex, and total lean mass were the only parameters independently related with BMD.
  
  
  CONCLUSIONS
  Therefore, chronic HCV infection in well nourished patients with preserved liver function does not cause osteoporosis.
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario, Universidad de La Laguna, Tenerife, Canary Islands, Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pelazas-González
authors.forename: Emilio
authors.initials: E
authors.lastname: González-Reimers
authors.forename: María Remedios
authors.initials: MR
authors.lastname: Alemán-Valls
authors.forename: Francisco
authors.initials: F
authors.lastname: Santolaria-Fernández
authors.forename: Javier
authors.initials: J
authors.lastname: López-Prieto
authors.forename: Antonieta
authors.initials: A
authors.lastname: González-Díaz
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Gómez-Sirvent
authors.forename: María José
authors.initials: MJ
authors.lastname: de la Vega-Prieto
mesh_terms: D000328:Adult; D015519:Bone Density; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000209:etiology*