Osteodystrophy in patients with chronic hepatitis and liver cirrhosis |
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Authors: | Katsunobu Tsuneoka Yukihiko Tameda Koujirou Takase Takeshi Nakano |
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Institution: | (1) First Department of Internal Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu, 514 Mie, Japan;(2) Department of Laboratory Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu, 514 Mie, Japan |
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Abstract: | Bone mineral density (BMD) of the lumber vertebrae and factors related to bone metabolism were determined in patients with
chronic viral hepatitis and patients with liver cirrhosis to clarify correlations between hepatic dysfunction, considered
to be one of the causes of hepatic osteodystrophy, and decrease in bone mass. BMD of the second to fourth lumbar vertebrae
was determined with a Lunar (Madison, WI, USA) DPX, a dual-energy X-ray absorptiometry diagnostic system. BMD was significantly
lowest in patients with liver cirrhosis, followed by patients with chronic hepatitis, and healthy subjects, in this order.
There was a significantly positive but weak correlation between albumin and BMD. Levels of 25(OH)D and 1,25(OH)2D were significantly lower in patients with liver cirrhosis than in those with chronic hepatitis. BMD and vitamin D were decreased
in all patients whose cholinesterase (ChE) was below 0.3ΔpH. Urinary pyridinoline(Upyr) was significantly higher in the patients
with liver cirrhosis, in whom bone mass was decreased, than in the patients with chronic hepatitis, whereas serum osteocalcin
levels were distributed in the upper normal range in patients with chronic hepatitis and those with liver cirrhosis. There
was a positive correlation between 25(OH)D and serum osteocalcin levels in patients with liver cirrhosis. These results indicate
that osteogenesis is decreased and suggest that the decrease in BMD which occurs in viral liver cirrhosis, probably related
to decreased, bone formation and slight promotion of bone resorption, reflects deranged hepatic function. This is the first
report of Upyr and urinary deoxypyridinoline (UDpyr) determination in patients with liver cirrhosis and patients with chronic
hepatitis. The negative correlation of Upyr and UDpyr with ChE is a novel finding. |
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Keywords: | osteoporosis liver cirrhosis vitamin D urinary pyridinoline urinary deoxypyridinoline |
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