Bone mineral density in patients with nonalcoholic steatohepatitis among end-stage liver disease patients awaiting liver transplantation
| Autor: | Elvin Hardy, Alan L. Burshell, Patchaya Boonchaya-anant, Brian B. Borg |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
musculoskeletal diseases
Adult Male medicine.medical_specialty Alcoholic liver disease Cirrhosis Endocrinology Diabetes and Metabolism medicine.medical_treatment Population Osteoporosis Liver transplantation Gastroenterology Liver disease Endocrinology Bone Density Internal medicine medicine Humans education Retrospective Studies education.field_of_study business.industry Liver Diseases General Medicine Middle Aged musculoskeletal system medicine.disease digestive system diseases Liver Transplantation Osteopenia Fatty Liver Female Viral hepatitis business |
| Zdroj: | Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 19(3) |
| ISSN: | 1934-2403 |
| Popis: | Several studies have shown that patients with end-stage liver disease (ESLD) have lower bone mineral density (BMD) and a higher prevalence of osteoporosis compared to an age-matched population. Hyperinsulinemia and insulin resistance are typically associated with increased BMD. We hypothesized that patients with nonalcoholic steatohepatitis (NASH) and underlying insulin resistance may have higher BMD than patients with cirrhosis from other causes.We performed a retrospective chart review of patients with ESLD who underwent liver transplant evaluation at Ochsner Clinic Foundation and had a BMD study as part of initial work up and compared BMD values of patients diagnosed with NASH to patients with cirrhosis due to other causes. Patients were categorized into 3 groups based on the etiology of their liver disease as NASH, alcoholic cirrhosis, or viral hepatitis C or B (HCV/HBV).A total of 63 patients met the study inclusion criteria, including 15 with NASH, 17 with alcoholic cirrhosis, and 31 with HCV/HBV. The overall prevalence rates of osteopenia and osteoporosis were 44% and 12%, respectively. BMD values were higher in the NASH group than the HCV/HBV group at lumbar spine, total hip, and femoral neck (P = .01, .03, and .02, respectively). There were no statistical differences in BMD values between NASH and alcoholic cirrhosis groups at any site.We found a high prevalence of low BMD among patients with ESLD awaiting liver transplantation. NASH patients had higher BMDs than HCV/HBV patients. The effects of NASH and insulin resistance on bone are complex and should be examined further. |
| Databáze: | OpenAIRE |
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