scholarly journals Features of Changes in Blood Parameters of Some Laboratory Syndromes and their Constellations in Patients with Liver Cirrhosis with Disorders of Bone Mineral Density

2021 ◽  
Vol 2-3 (35-36) ◽  
pp. 23-26
Author(s):  
N. Drobinska ◽  
◽  
O. Abrahamovych ◽  
Z. Bilous ◽  
M. Ferko ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Liver Cirrhosis ◽  
Bone Mineral ◽  
Density Lipoprotein ◽  
Blood Parameters ◽  
Bone Lesions ◽  
Mineral Density ◽  
Prothrombin Index ◽  
Cytolysis Syndrome ◽  
Insufficiency Syndrome

Introduction. Investigation of changes in certain laboratory blood parameters, and verification with their help of laboratory syndromes, and detection of constellations of laboratory syndromes in patients with liver cirrhosis (LC), which is possible for clinicians of all levels of medical care, need to clarify their features, which would suspect or verify disorders of bone mineral density (DBMD). The aim of the study. Investigate the features of changes in blood parameters of some laboratory syndromes and their constellations in patients with liver cirrhosis with disorders of bone mineral density. Materials and methods. 90 patients (27 women (30.0 %) and 63 men (70.0 %) aged 18 to 66 years) with LC were stratified into several groups: experimental (EG) (patients with LC with DBMD) (72 patients (80.0 %))), from which two subgroups were formed - EG A (patients with LC with osteopenia) (46 patients (63.9 %))), and EG B (patients with LC with osteoporosis) (26 patients (36.1 %)))) and the comparison group (CG) (patients with LC without DBMD) (18 patients (20.0 %))). Among the laboratory syndromes and their blood parameters were studied such as: cytolysis (increased in plasma alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST)), mesenchymal-inflammatory syndrome (increased thymol test (TT) and/or gamma-globulins), hepatocellular insufficiency (decreased fibrinogen, prothrombin index (PTI), total protein, or albumin), cholestasis (increased alkaline phosphatase (AP), gamma-glutamyltranspeptidase (GGTP), total bilirubin), porto-systemic shunting (decreased sodium and/or potassium, and/or increased creatinine) and dyslipidemia (increased serum cholesterol, B-lipoproteins, triglycerides, low-density lipoprotein (LDL), decreased high-density lipoprotein (HDL)). The study was performed in three stages, the first of which studied the features of laboratory syndromes and blood parameters that characterize them, the second - constellations of laboratory syndromes, and the third - the simultaneous manifestation of a number of different laboratory syndromes in patients with LC with DBMD, osteopenia and osteoporosis. Each stage involved three steps: the first was to study the frequency of laboratory syndromes and their laboratory blood parameters in patients with LC and determine their share in each of the study groups, the second was to identify significant differences in the frequency of cases, and the third was to identify a direct stochastic relationship between the studied trait and DBMD, including osteopenia and osteoporosis. Results. After performing all three stages and each of the planned steps, it was found that laboratory syndromes and their constellations are more common among patients with bone lesions. However, there are statistically significant differences in the frequency of cases between EG and CG in the case of a decrease in HDL and the simultaneous manifestation of five different laboratory syndromes; between EG A and CG - decrease in HDL and simultaneous manifestation of two and three different laboratory syndromes; between EG B and CG - increase in AP, decrease in HDL and simultaneous manifestation of five different laboratory syndromes; between EG A and EG B - cytolysis syndrome, increase in AST, gamma-globulins, AP, constellation of cytolysis syndrome with hepatocellular insufficiency syndrome or cholestasis syndrome and constellation of all three syndromes. Confirmed direct stochastic association was found: with all manifestations of DBMD - increase in TT, a decrease in HDL, and constellations of cytolysis, mesenchymal-inflammatory and dyslipidemic syndrome, which may be supplemented by hepatocellular insufficiency syndrome and/or cholestasis syndrome; with osteopenia - increase in TT, increase in blood cholesterol, decrease in HDL, and constellations containing dyslipidemia syndrome and supplemented by mesenchymal-inflammatory, and/or cytolysis and/or hepatocellular insufficiency and/or cholestasis syndromes, and simultaneously only two laboratory syndromes in a patient with LC; with osteoporosis - increase in blood AST, TT, gamma-globulins, AP, decrease in PTI, potassium, HDL, the presence of cytolysis, cholestasis syndromes, constellations of cytolysis syndrome with hepatocellular insufficiency syndrome and/or cholestasis syndrome, which are supplemented by mesenchymal-inflammatory and dyslipidemic syndrome, and the simultaneous manifestation only three or five different laboratory syndromes. Conclusions. Laboratory syndromes, blood parameters that characterize them, and constellations of laboratory syndromes have certain features in patients with cirrhosis of the liver with disorders of bone mineral density, as in most cases are more common in patients with bone lesions and have a confirmed stochastic relationship with disorders of mineral density bone tissue in general, and osteopenia and osteoporosis separately. Keywords: cirrhosis, bone mineral density, osteopenia, osteoporosis, cytolysis, mesenchymal-inflammatory, hepatocellular insufficiency, cholestasis, porto-systemic shunting, dyslipidemia, alanine aminotransferase, aspartate aminotransferase, thymol test, total protein, albumin, gamma-globulin, fibrinogen, prothrombin index, alkaline phosphatase, gamma-glutamyltranspeptidase, bilirubin, sodium, potassium, creatinine, cholesterol, B-lipoproteins, triglycerides, low-density lipoproteins, high-density lipoproteins.

scholarly journals The effect of plasma lipids and lipid lowering interventions on bone mineral density: a Mendelian randomization study

2018 ◽  
Author(s):  
Jie Zheng ◽  
Marie-Jo Brion ◽  
John P. Kemp ◽  
Nicole M. Warrington ◽  
Maria-Carolina Borges ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Standard Deviation ◽  
Bone Mineral ◽  
Mendelian Randomization ◽  
Causal Effect ◽  
Plasma Lipid ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Levels ◽  
Mineral Density

AbstractStatin treatment increases bone mineral density (BMD) and reduces fracture risk, but the underlying mechanism is unclear. We used Mendelian randomization (MR) to assess whether this relation is explained by a specific effect in response to statin use, or by a general effect of lipid-lowering. We utilized 400 single nucleotide polymorphisms (SNPs) robustly associated with plasma lipid levels and results from a heel BMD GWAS (derived from quantitative ultrasound) in 426,824 individuals from the UK Biobank. We performed univariate and multivariable MR analyses of low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglyceride levels on BMD. To test whether the effect of statins on BMD was mediated by lowering lipid levels, MR was repeated with and without SNPs in theHMGCRregion, the gene targeted by statins. Univariate MR analyses provided evidence for a causal effect of LDL-C on BMD (β= −0.060; −0.084 to −0.036; P = 4×10-6; standard deviation change in BMD per standard deviation change in LDL-C, with 95% CI), but not HDL or triglycerides. Multivariable MR analysis suggested that the effect of LDL-C on BMD was independent of HDL-C and triglycerides, and sensitivity analyses involving MR Egger and weighted median MR approaches suggested that the LDL-C results were robust to pleiotropy. MR analyses of LDL-C restricted to SNPs in theHMGCRregion showed similar effects on BMD(β= −0.083; −0.132 to −0.034; P = 0.001) to those excluding these SNPs (β= −0.063; −0.090 to −0.036; P = 8×10-6). Bidirectional MR analyses provided some evidence for a causal effect of BMD on plasma LDL-C levels. Our results suggest that effects of statins on BMD are at least partly due to their LDL-C lowering effect. Further studies are required to examine the potential role of modifying plasma lipid levels in treating osteoporosis.

Gaucher disease: alendronate disodium improves bone mineral density in adults receiving enzyme therapy

Blood ◽  
2004 ◽  
Vol 104 (5) ◽  
pp. 1253-1257 ◽  
Author(s):  
Richard J. Wenstrup ◽  
Laurie Bailey ◽  
Gregory A. Grabowski ◽  
Jay Moskovitz ◽  
Alan E. Oestreich ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Gaucher Disease ◽  
Bone Lesions ◽  
X Rays ◽  
Enzyme Therapy ◽  
Mineral Density ◽  
Focal Lesions ◽  
Enzyme Replacement

Abstract Symptomatic patients with Gaucher disease (GD) (acid β-glucosidase [Gcase] deficiency) are treated with injectable human recombinant GCase. Treatment results in significant decreases in lipid storage in liver, spleen, and bone marrow, but the generalized osteopenia and focal bone lesions present in many adult patients are refractory to treatment. A double-blind, 2-arm, placebo-controlled trial of alendronate (40 mg/d) was performed in adults with GD who had been treated with enzyme for at least 24 months. Primary therapeutic endpoints were improvements in (1) bone mineral density (BMD) and content (BMC) at the lumbar spine, and (2) focal lesions in x-rays of long bones assessed by a blinded reviewer. There were 34 patients with GD type 1 (age range, 18-50 years) receiving enzyme therapy who were randomized for this study. After 18 months, ΔBMD at the lumbar spine was 0.068 ± 0.21 and 0.015 ± 0.034 for alendronate and placebo groups, respectively (P = .001). Long-bone x-rays showed no change in focal lesions or bone deformities in any subject in either arm. Alendronate is a useful adjunctive therapy in combination with enzyme replacement therapy (ERT) for the treatment of GD-related osteopenia in adults, but it cannot be expected to improve focal lesions.

scholarly journals Frequency of Low Bone Mineral Density (BMD) in Patients with Liver Cirrhosis

2021 ◽  
pp. 47-52
Author(s):  
Ihsanullah Rajar ◽  
Nasrullah Aamer ◽  
Narindar Kumar ◽  
Prem Kumar ◽  
Kapeel Raja ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Liver Cirrhosis ◽  
Bone Mineral ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Mineral Density ◽  
Cross Sectional ◽  
T Score ◽  
Low Bone Mineral Density ◽  
Femur Neck

Objective: The objective of this study was to evaluate the low bone mineral density (BMD) in patients with liver cirrhosis. Methodology: This cross sectional study on 151 Liver cirrhotic patients was conducted at Liaquat University Hospital Hyderabad/Jamshoro. This study duration was 6 months, July 2015 to December 2015. The Assessment of bone mineral density (BMD) for each relevant patient was done using ultrasound impedance Dual Energy X-ray Absorptiometry  (DEXA) by senior pathologist having ≥05 years of experience, across the calcaneum, at lumbar spine  (LS) and femur neck (FN),  were computed by using computer supported device. The BMD was expressed in terms of T score. The WHO standard value was utilized to define the low BMD / osteoporosis is T score -1.5. Results: The mean age of subjects was 31.32±6.18 years. Out of all, 62.9% were males whereas 37.1% were females. About 21% patients had low/abnormal bone mineral density (BMD). Among these, 17.9% had bone mineral density (BMD) of -1.5 to -2.5 and 4% had BMD of <-2.5. Rest of 78.1% patients had a normal (>-1.5) bone mineral density (BMD). Majority of patients, 63.6% had a CTP grade B of liver cirrhosis, whereas 22.5% had A grade and 13.9% had C grade of liver cirrhosis. Conclusion: Conclusively, the risk of low bone mineral density (BMD) was evidently high for patients with hepatic cirrhosis. Male gender and age above 30 years were found at greater risk and CTP grade B of cirrhosis was most common.

scholarly journals Choroidal Thickness in Relation to Bone Mineral Density with Swept-Source Optical Coherence Tomography

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Lin Jiang ◽  
Yiwen Qian ◽  
Qingjian Li ◽  
Jing Jiang ◽  
Yu Zhang ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Optical Coherence Tomography ◽  
Bone Mineral ◽  
Choroidal Thickness ◽  
Density Lipoprotein ◽  
Normal Subjects ◽  
Mineral Density ◽  
Swept Source ◽  
X Ray ◽  
Significant Difference

Purpose. To assess whether bone mineral density, indicated by the lumbar X-ray scan, is related to changes in choroid thickness in normal subjects. Methods. This study included 355 patients with decreased bone mineral density and 355 age- and sex-matched healthy subjects. Lumbar BMD was measured by dual-energy X-ray absorptiometry (DXA). Choroidal thickness was measured using swept-source optical coherence tomography (SS-OCT). Blood pressure (BP), cholesterol, triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were recorded on the same day. Results. There was a significant difference in average choroidal thickness between low BMD subjects and normal subjects p = 0.003 . The BP, cholesterol, triglyceride, HDL, and LDL showed no significant difference between the two groups. The correlations showed that average choroidal thicknesses were associated with BMD in the entire population (r = 0.125, p = 0.001 ). Conclusion. The choroidal thickness is thinner in low BMD populations compared with normal individuals. There is a strong positive correlation of choroidal thickness with BMD, regardless of age, sex, and other demographic and clinical factors.

scholarly journals Comparative Efficacy and Side Effects of the Treatment of Euthyroid Goiter with Levo-Thyroxine or Triiodothyroacetic Acid

2003 ◽  
Vol 88 (11) ◽  
pp. 5287-5292 ◽  
Author(s):  
G. Brenta ◽  
M. Schnitman ◽  
O. Fretes ◽  
E. Facco ◽  
M. Gurfinkel ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Side Effects ◽  
Bone Mineral ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Thyroid Volume ◽  
Mineral Density ◽  
Free T4 ◽  
Chronic Thyroiditis ◽  
Femoral Bone Mineral Density

Abstract Euthyroid goiter is usually treated with TSH-inhibitory doses of levo-T4 (l-T4). Because triiodothyroacetic acid (TRIAC) decreases TSH levels, the following study was perfomed: 36 euthyroid goitrous female patients (no cancer or chronic thyroiditis) were randomized to TRIAC (19.6 μg/kg) (n = 19) or l-T4 (1.7 μg/kg) (n = 17) treatment during 11 months. Goiter volume; lumbar and femoral bone mineral density; serum osteocalcin; deoxypyridinoline; TSH; free T4; total, high-density lipoprotein, and low-density lipoprotein cholesterol; and triglycerides were measured before and after the study period. Student’s t test and χ2 analysis were performed. TSH values (microunits per milliliter) in the TRIAC and l-T4 groups were: 1.91 ± 0.6 (basal) and 0.180 ± 0.1 (after) and 2.1 ± 2.5 (basal) and 0.180 ± 0.3 (after), respectively. Thyroid volume decreased 37.9 ± 35.4% in the TRIAC patients and 14.5 ± 39.5% in the l-T4 group (P = 0.069). Forty-two percent of the goiters with TRIAC reduced more than 50% their initial volume vs. 17.7% with l-T4 (P = 0.15). With TRIAC, patients experienced fewer side effects. No differences in the changes of bone mineral density, serum deoxypyridinoline, osteocalcin, or the lipid profile were observed between both groups. The present results show that TRIAC is more effective than l-T4 in the reduction of goiter size, with comparable effects on peripheral parameters.

Association between vitamin D and bone mineral density in post-menopausal women with metabolic syndrome

2015 ◽  
Vol 22 (1) ◽  
pp. 7-14
Author(s):  
Jolanta Dadonienė ◽  
Alma Čypienė ◽  
Egidija Rinkūnienė ◽  
Jolita Badarienė ◽  
Jelizaveta Burca ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Metabolic Syndrome ◽  
Vitamin D ◽  
Bone Mineral ◽  
Density Lipoprotein ◽  
Serum Glucose ◽  
Mineral Density ◽  
Normal Bone Mineral Density ◽  
Menopausal Women ◽  
Post Menopausal

Background. The aim of this study was to identify the relation between vitamin D level and mineral bone density in post-menopausal women with metabolic syndrome. Materials and methods. This study included 100 post-menopausal women at age between 50 and 65 with metabolic syndrome. All participants underwent anthropometric measurements. Laboratory tests were performed to determine lipid profile, serum glucose, creatinine, C-reactive protein, vitamin D (25(OH) D), ionized calcium concentration and urine albumin / creatinine ratio. Bone mineral density of the lumbar spine (L1– L4) and total hip was measured by dual-energy X-ray absorptiometry. Results. According to the vitamin D concentration level in the blood all women were divided into four groups: the average failure was observed in 57%, mild failure in 33%, severe failure in 5%; and only 5% of women had normal vitamin levels. The mean 25(OH) D level was 47.40  ±  16.91  nmol/l. According to bone densitometry we found that 77% of all participants had normal bone mineral density, 22% had osteopenia and 5% were diagnosed with osteoporosis. No correlation was found between bone mineral density and 25(OH)  D levels. We found a weak positive correlation between high density lipoprotein cholesterol and 25(OH) D (r = 0.3, p 

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