Patients With Cirrhosis Have Elevated Bone Turnover but Normal Hepatic Production of Osteoprotegerin
| Autor: | Niklas Rye Jørgensen, Søren Møller, Karen Vagner Danielsen, Gitte Lund Christensen, Nina Kimer, Sarah Seberg Diemar |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Cirrhosis Endocrinology Diabetes and Metabolism Clinical Biochemistry Context (language use) Biochemistry Bone remodeling chemistry.chemical_compound Endocrinology N-terminal telopeptide Osteoprotegerin Internal medicine medicine Humans Osteodystrophy Adaptor Proteins Signal Transducing Aged biology business.industry Biochemistry (medical) Middle Aged medicine.disease Hepatobiliary Elimination Bone Diseases Metabolic Liver chemistry Case-Control Studies Osteocalcin biology.protein Sclerostin Female Bone Remodeling business Biomarkers |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 107:e980-e995 |
| ISSN: | 1945-7197 0021-972X |
| Popis: | Context Severe osteodystrophy is common in patients with liver dysfunction. Markers of bone metabolism may help in early diagnosis of osteodystrophy and in understanding underlying pathophysiological mechanisms. Objective To elucidate changes in bone metabolism associated with cirrhosis and to determine the route of elimination for the markers. Methods Case–control study at a public university hospital. Fifty-nine patients with cirrhosis (47 alcoholic and 12 nonalcoholic cirrhosis) and 20 controls were included. Participants underwent catheterization of the femoral artery, and the hepatic, renal, and femoral veins with collection of blood from all 4 sites. Regional arteriovenous differences in concentrations of bone metabolism markers were determined: procollagen of type I collagen propeptide (PINP), C-terminal cross-linking telopeptide of type I collagen (CTX), osteocalcin, tartrate-resistant acid phosphatase isoform 5b (TRAcP5b), osteoprotegerin (OPG), and sclerostin and correlated with degree of disease (Child–Pugh classification). Results PINP concentration was higher (median: 87.9 µg/L) in patients with cirrhosis than in controls (52.6 µg/L) (P = .001), while hepatic extraction was lower (4.3% vs 14.5%) (P < .001). Both CTX and TRAcP5b were higher in patients with cirrhosis (340 ng/L and 3.20 U/L) than in controls (215 ng/L and 1.60 U/L) (P < .001 and P < .0001). Hepatic sclerostin extraction was lower in patients with cirrhosis (14.6%) than in controls (28.7%) (P < .0001). In both groups OPG showed a hepatic release rate (production) of 6%. Conclusion Patients with cirrhosis have increased bone resorption, but unaltered bone formation. Sclerostin is eliminated through the liver while OPG is produced in the liver. Bone markers may prove useful in evaluating bone turnover in patients with cirrhosis. |
| Databáze: | OpenAIRE |
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