title: The impact of osteoporosis on health-related quality of life in patients after liver transplantation - a pilot study.
abstract: BACKGROUND
  Liver transplantation (LT) is now a well-established procedure with 5-year survival rates over 70%, and one of its ultimate goals is the improvement of patient health-related quality of life (HRQOL). Osteoporosis remains a serious potential complication of LT, leading to fragility fractures, pain, and functional impairment.
  
  
  OBJECTIVE
  To assess the degree of osteoporosis and the impact of fragility fractures on HRQOL in patients with chronic liver diseases treated with LT.
  
  
  METHODS
  Twenty-seven patients (14 female, 13 male) at a median period of 3.5 years post LT participated in the study. HRQOL was assessed by Short Form-36 and PBC-40 instruments. Bone mineral density (BMD) in the lumbar spine and hip neck were measured by dual-energy X-ray absorptiometry. Physical activity was assessed by questionnaire. Data on the duration of the liver disease, time from LT, and fragility fractures were also collected.
  
  
  RESULTS
  As many as 74.1% of the patients had reduced BMD (t-score < -1.0 SD) in the hip. Mean values of the spine and hip BMD z-scores were -1.1 and -0.9 SD, respectively. Time after LT, percentage of lean tissue, and physical activity were positively associated with BMD. The prevalence of fractures was 48%. We did not find significant differences in age, gender, body composition parameters, physical activity, BMD, and HRQOL scores between the subjects with and without fractures.
  
  
  CONCLUSIONS
  We found a high prevalence of fragility fractures and a decreased BMD in LT recipients. Patients with a history of fractures had similar HRQOL scores to those without fractures.
authors.affiliation: Hepatology and Internal Medicine Unit, Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Raszeja-Wyszomirska
authors.affiliation: Liver Research Laboratories, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Kucharski
authors.affiliation: Department of Physical Culture and Health Promotion, University of Szczecin, Szczecin, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kotarska
authors.affiliation: Department of Environmental Hazard Prevention and Allergology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Marta
authors.initials: M
authors.lastname: Zalewska
authors.affiliation: Department of Hypertension and Internal Medicine, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Miazgowski
keywords: liver transplantation; osteoporosis