Assessing bone status in patients awaiting liver transplantation.

Abstract

UNLABELLED:

Osteoporosis is common in liver transplant recipients as a result of both iatrogenic factors and preexisting hepatic osteodystrophy.

OBJECTIVES:

To assess the prevalences of osteoporosis and fractures and to identify risk factors for these two abnormalities in patients awaiting liver transplantation for end-stage liver disease.

METHODS:

Between January 2006 and December 2007, patients on a liver transplant waiting list underwent a routine evaluation comprising the identification of risk factors for osteoporosis, radiographs of the spine, bone mineral density measurements (BMD), and laboratory tests (phosphate and calcium levels, hormone assays, liver function tests, and bone turnover markers).

RESULTS:

We studied 99 patients (70 males and 20 females; mean age, 55 ± 8 years) including 75% with alcohol-induced cirrhosis with or without hepatocarcinoma. Among them, 36% had radiographic vertebral fractures, 38% had osteoporosis, 35% had osteopenia, and 88% had vitamin D insufficiency or deficiency (25(OH)vitamin D3<20 ng/mL). Lower BMD values were associated with vertebral fractures; the odds ratios and 95% confidence intervals for each BMD decrease of 1 SD were as follows: spine, 1.45 (95%CI, 1.1-1.9); total hip, 2.1 (95%CI, 1.3-3.2); and femoral neck, 2 (95%CI, 1.3-3.1) (P<0.05). Levels of bone resorption markers correlated negatively with BMD at the spine and hip. The Model for End-Stage Liver Disease score correlated negatively with hip BMD.

CONCLUSION:

Our findings suggest high prevalences of low BMD values and vertebral fractures among patients awaiting liver transplantation. Bone status should be evaluated routinely in candidates to liver transplantation.

• Authors: Cécile Wibaux, Isabelle Legroux-Gerot, Sébastien Dharancy, Emmanuel Boleslawski, Nicole Declerck, Valérie Canva, Philippe Mathurin, François-René Pruvot, Bernard Cortet
• Journal: Joint bone spine (Joint Bone Spine) Vol. 78 Issue 4 Pg. 387-91 (Jul 2011) ISSN: 1778-7254 [Electronic] France
• PMID: 21565541 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Topics

• Absorptiometry, Photon
• Bone Density
• Bone and Bones (diagnostic imaging, metabolism)
• Clinical Chemistry Tests
• Cross-Sectional Studies
• End Stage Liver Disease (complications, metabolism, surgery)
• Female
• Humans
• Liver Transplantation
• Lumbar Vertebrae (diagnostic imaging, metabolism)
• Male
• Middle Aged
• Osteoporosis (complications, diagnosis, metabolism)
• Prospective Studies
• Risk Factors
• Waiting Lists