| Abstract: | Assessment for both trabecular and cortical osteoporosis wascarried out in 36 unselected patients with chronic cholestaticliver disease of whom a number had received corticosteroidsduring the course of their illness. Symptoms suggestive of osteoporosiswere present in 42 per cent of patients of whom 11 per centhad evidence of one or more wedged or collapsed vertebrae. Therewas a highly significant decrease in the cortical area (totalarea ratio of the second metacarpal (p = 0.05), bone mineralcontent at the metaphyseal site of the radius (p = 0.01) andthe total trabecular bone volume of the iliac crest biopsies(p = 0.005) in the 31 female patients when compared with ageand sex-matched healthy controls). There was a nonsignificantdecrease in total trabecular bone volume of the iliac crestand bone mineral content of the radial metaphysis in the malescompared with age and sex-matched controls but the corticalplate thickness of the iliac crest (p = 0.005) and bone mineralcontent of the radial diaphysis (p = 0.02) were significantlyhigher. In total, 42 per cent of patients had evidence of eitherexcessive cortical (28 per cent) and/or trabecular (36 per cent)bone loss as judged by radiological and histological criteria.Only the total trabecular bone volume of the iliac crest, ofall the parameters measured was significantly (p = 0.02) lowerin patients with backache compared with those without back pain.Significantly greater bone loss was demonstrated at all sitesmeasured in those patients that were receiving or had receivedcorticosteroids in the past.
*Present address: Department od Histopathology,University Hospitalof Wales,Health Park,Cardiff. |
