title: Vitamin D status, bone metabolism and bone mass in patients with alcoholic liver cirrhosis.
abstract: BACKGROUND
  Osteoporosis is seen in some 12-50 % patients with liver cirrhosis. Detrimental effects of alcohol are exerted directly on the bone cells and indirectly on hormones. Vitamin D is involved in osteoblast differentiation, bone matrix synthesis and bone mineralization, as well as in its decomposition. Vitamin D deficiency has been reported in about 2/3 patients with liver cirrhosis.
  
  
  OBJECTIVE
  Determination of vitamin D status, bone metabolic activity and bone mass in patients with alcoholic liver cirrhosis (ALC).
  
  
  METHODS
  Thirty male patients with ALC were investigated in the period October 2011- March 2012. Total vitamin D, parathormone, osteocalcin and CrossLaps were determined by the ECLIA method (electrochemiluminiscence immunoassay) using Elecsys 2010 analyzer. Bone mineral density was measured by means of dual-energy x-ray absorptiometry (DXA) using the Lunar Prodigy. Result analysis was performed using descriptive statistics and hypothesis testing, as well as nonparametric one-way analysis of variance, Kruskal-Wallis test, Mann-Whitney U-test, Pearson correlation coefficient.
  
  
  RESULTS
  Deficiency in vitamin D (< 50 nmol/l) was noted in 66.66 % patients, with highest prevalence in Child-Pugh C class patients (chi-square = 5.878, p < 0.05). Osteocalcin levels were below the lower limit of normal in 86.7 % patients. CrossLaps was increased in only 20 % patients, but a significant increase was noted in Child-Pugh C class patients. Osteoporosis was diagnosed in 20 % of patients, with no correlation with disease severity and vitamin D status.
  
  
  CONCLUSIONS
  Vitamin D deficiency is present in patients with ALC. Decrease in bone formation and bone mass is most probably multicausal (Tab. 2, Fig. 1, Ref. 30).
authors.forename: Z
authors.initials: Z
authors.lastname: Savic
authors.forename: D
authors.initials: D
authors.lastname: Damjanov
authors.forename: N
authors.initials: N
authors.lastname: Curic
authors.forename: B
authors.initials: B
authors.lastname: Kovacev-Zavisic
authors.forename: L
authors.initials: L
authors.lastname: Hadnadjev
authors.forename: J
authors.initials: J
authors.lastname: Novakovic-Paro
authors.forename: S
authors.initials: S
authors.lastname: Nikolic
mesh_terms: D000368:Aged; D015519:Bone Density; D016723:Bone Remodeling; D001842:Bone and Bones / Q000378:metabolism; D015331:Cohort Studies; D003094:Collagen / Q000097:blood; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000453:epidemiology*; D010446:Peptide Fragments / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology*
chemical_list: D010446:Peptide Fragments; C110762:glutamyl-lysyl-alanyl-histidyl-aspartyl-glycyl-glycyl-arginine; D003094:Collagen