scholarly journals Study of Correlation of Severity of Hepatic Cirrhosis with Severity of Bone Changes Measured by BMD (Bone Mineral Density)

2013 ◽  
Vol 22 (2) ◽  
pp. 41-46 ◽  
Author(s):  
Md Ashraful Alam ◽  
Nooruddin Ahmed ◽  
Sahinul Alam ◽  
Mamun Al Mahtab
Keyword(s):  
Bone Mineral Density ◽  
Liver Cirrhosis ◽  
Liver Disease ◽  
Bone Loss ◽  
Bone Mineral ◽  
Bone Disease ◽  
Liver Diseases ◽  
Hepatic Cirrhosis ◽  
Mineral Density ◽  
Bone Changes

Background & Aim Metabolic bone disease is common among patients with chronic liver disease and still it is underestimated complication in liver cirrhosis. The prevalence and presentation of bone disease in chronic liver diseases have been poorly described except for cholestatic liver diseases. This study aims at evaluation of the prevalence and degree of bone changes in patients with cirrhosis and to correlate severity of hepatic cirrhosis with the severity of bone changes. Patients and Methods Bone mineral density (BMD) was studied using dual energy X-ray absorptiometry (DEXA) in 60 subjects of 15-45 years old. Of them 30 subjects are patients with liver cirrhosis and rest of the 30 subjects were control group without having liver disease or any other chronic disease. The diagnosis of cirrhosis was based on clinical, biochemical, and ultrasonographic findings. Patients with renal impairment, cholestatic liver disease, chronic lung disease, prolonged bed ridden patients or deformity of spine, pelvis or wrist were excluded from the study. Results of BMD were then correlated with the Child score. Results Eighteen (60%) patients had decreased bone mineral density (BMD). Of which 15 (50%) patients have got osteopenia and 3 (10%) patients have got osteoporosis. No correlation was found between the T-score and Child Paugh score (p =0.236). Significant correlations were found between BMD and serum bilirubin. Conclusion Liver cirrhosis is a risk factor for the development of bone loss and there is a high prevalence of BMD disorders in cirrhotic patients. The severity of bone loss is not related to the severity of liver disease. Hyperbilirubinemia and low albumin is a contributing factor to altered bone mineral density in patients with liver cirrhosis DOI: http://dx.doi.org/10.3329/bjmed.v22i2.13588 Bangladesh J Medicine 2011; 22: 41-46

scholarly journals Study of local and generalized bone loss in patients with rheumatoid arthritis

2019 ◽  
Vol 57 (3) ◽  
pp. 328-332
Author(s):  
I. S. Dydykina ◽  
P. O. Kozhevnikova
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Bone Loss ◽  
Chronic Inflammation ◽  
Bone Mineral ◽  
Mineral Density ◽  
Bone Changes ◽  
Hands And Feet ◽  
The Relationship ◽  
Peripheral Skeleton

Chronic inflammation in rheumatoid arthritis (RA) is accompanied by local (periarticular osteoporosis) and generalized loss of bone mineral density in the axial and peripheral skeleton. The paper discusses the relationship between local and generalized bone loss and the contribution of various factors to bone changes. Information about the contribution of age at the onset of RA to the progression of destructive changes in the hands and feet and the rate of generalized bone loss in the axial and peripheral skeleton are contradictory.

scholarly journals Relation of bone mineral density with severity of liver cirrhosis

2018 ◽  
Vol 5 (4) ◽  
pp. 809
Author(s):  
P. D. Meena ◽  
Amandeep Singh ◽  
C. L. Nawal ◽  
Radhey Shyam Chejara ◽  
Swapnil Jain ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Liver Cirrhosis ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Bone Mineral ◽  
Pathologic Fracture ◽  
Chronic Liver ◽  
Mineral Density ◽  
Class A ◽  
Class C

Background: Osteoporosis is commonly associated with chronic liver disease. Pathologic fracture in osteoporotic patients affects quality of life as well as decrease life expectancy. Around 40% of patients with chronic liver disease may experience osteoporotic fracture. The present study was undertaken to observe the relation of bone mineral density (BMD) with severity of liver cirrhosis along with effects of smoking and alcohol.Methods: A total of 187 liver cirrhosis patients who were admitted in SMS Hospital were taken for study and were classified into class A, B, C as per Child Turcot Pugh’s classification, after applying inclusion and exclusion criteria. All patients underwent standard laboratory testing and bone densitometric studies of the lumbar spine using dual X-ray absorptiometry (DEXA) scan. Statistical analysis done.Results: The bone mineral density was significantly low in Class C. Class C have 41 patients of osteoporosis out of 62 whereas only 16 patients have osteoporosis in Class B and only 1 case of osteoporosis in class A. Hypocalcemia and hypophosphatemia were more in class C as in comparison to class A and B. Also, chronic smoking and alcohol intake were strongly associated with the severity of cirrhosis.Conclusions: The prevalence of osteopenia and osteoporosis is higher in cirrhotic patients and significantly increases with severity. Hypocalcemia and hypophosphatemia are also associated with the cirrhosis. Thus, patients should undergo routine bone densitometry assessment and, if necessary, to be treated for osteoporosis

Impaired Estrogen Sensitivity in Bone by Inhibiting Both Estrogen Receptor a and b Pathways*

2020 ◽  
Author(s):  
Lungwani Muungo
Keyword(s):  
Bone Mineral Density ◽  
Estrogen Receptor ◽  
Bone Loss ◽  
Bone Turnover ◽  
Bone Mineral ◽  
Female Rats ◽  
Wild Type ◽  
Mineral Density ◽  
Transgenic Rats ◽  
Estrogen Sensitivity

Although it is well established that estrogen deficiencycauses osteoporosis among the postmenopausalwomen, the involvement of estrogen receptor (ER) in itspathogenesis still remains uncertain. In the presentstudy, we have generated rats harboring a dominantnegative ERa, which inhibits the actions of not only ERabut also recently identified ERb. Contrary to our expectation,the bone mineral density (BMD) of the resultingtransgenic female rats was maintained at the same levelwith that of the wild-type littermates when sham-operated.In addition, ovariectomy-induced bone loss wasobserved almost equally in both groups. Strikingly, however,the BMD of the transgenic female rats, after ovariectomized,remained decreased even if 17b-estradiol(E2) was administrated, whereas, in contrast, the decreaseof littermate BMD was completely prevented byE2. Moreover, bone histomorphometrical analysis ofovariectomized transgenic rats revealed that the higherrates of bone turnover still remained after treatmentwith E2. These results demonstrate that the preventionfrom the ovariectomy-induced bone loss by estrogen ismediated by ER pathways and that the maintenanceof BMD before ovariectomy might be compensatedby other mechanisms distinct from ERa and ERbpathways.

scholarly journals P129 Predictors of low bone mineral density in rheumatoid arthritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Malika A Swar ◽  
Marwan Bukhari
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Bone Mineral Density ◽  
Family History ◽  
Bone Loss ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Fragility Fracture ◽  
Mineral Density ◽  
History Of

Abstract Background/Aims  Osteoporosis (OP) is an extra-articular manifestation of rheumatoid arthritis (RA) that leads to increased fracture susceptibility due to a variety of reasons including immobility and cytokine driven bone loss. Bone loss in other populations has well documented risk factors. It is unknown whether bone loss in RA predominantly affects the femoral neck or the spine. This study aimed to identify independent predictors of low bone mineral density (BMD) in patients RA at the lumbar spine and the femoral neck. Methods  This was a retrospective observational cohort study using patients with Rheumatoid arthritis attending for a regional dual X-ray absorptiometry (DEXA) scan at the Royal Lancaster Infirmary between 2004 and 2014. BMD in L1-L4 in the spine and in the femoral neck were recorded. The risk factors investigated were steroid use, family history of osteoporosis, smoking, alcohol abuse, BMI, gender, previous fragility fracture, number of FRAX(tm) risk factors and age. Univariate and Multivariate regression analysis models were fitted to explore bone loss at these sites using BMD in g/cm2 as a dependant variable. . Results  1,527 patients were included in the analysis, 1,207 (79%) were female. Mean age was 64.34 years (SD11.6). mean BMI was 27.32kg/cm2 (SD 5.570) 858 (56.2%) had some steroid exposure . 169(11.1%) had family history of osteoporosis. fragility fracture history found in 406 (26.6%). 621 (40.7%) were current or ex smokers . There was a median of 3 OP risk factors (IQR 1,3) The performance of the models is shown in table one below. Different risk factors appeared to influence the BMD at different sites and the cumulative risk factors influenced BMD in the spine. None of the traditional risk factors predicted poor bone loss well in this cohort. P129 Table 1:result of the regression modelsCharacteristicB femoral neck95% CIpB spine95%CIpAge at scan-0.004-0.005,-0.003<0.01-0.0005-0.002,0.00050.292Sex-0.094-0.113,-0.075<0.01-0.101-0.129,-0.072<0.01BMI (mg/m2)0.0080.008,0.0101<0.010.01130.019,0.013<0.01Fragility fracture-0.024-0.055,0.0060.12-0.0138-0.060,0.0320.559Smoking0.007-0.022,0.0350.650.0286-0.015,0.0720.20Alcohol0.011-0.033,0.0 5560.620.0544-0.013,0.1120.11Family history of OP0.012-0.021,0.0450.470.0158-0.034,0.0650.53Number of risk factors-0.015-0.039,0.0080.21-0.039-0.075,-0.0030.03steroids0.004-0.023,0.0320.030.027-0.015,0.0690.21 Conclusion  This study has shown that predictors of low BMD in the spine and hip are different and less influential than expected in this cohort with RA . As the FRAX(tm) tool only uses the femoral neck, this might underestimate the fracture risk in this population. Further work looking at individual areas is ongoing. Disclosure  M.A. Swar: None. M. Bukhari: None.

scholarly journals SAT0477 A TWO-YEAR LONGITUDINAL STUDY COMPLETION, LONGITUNEAL STUDY, THE DIFFERENCE IN BONE LOSS IN PATIENTS WITH EROSIVE AND NON-EROSIVE HAND OSTEOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1195.2-1195
Author(s):  
K. Pavelka ◽  
L. Šenolt ◽  
O. Sleglova ◽  
J. Baloun ◽  
O. Růžičková
Keyword(s):  
Bone Mineral Density ◽  
Longitudinal Study ◽  
Lumbar Spine ◽  
Bone Loss ◽  
Bone Mineral ◽  
Hand Osteoarthritis ◽  
Mineral Density ◽  
Erosive Disease ◽  
Femur Neck ◽  
American College Of Rheumatology

Background:Hand osteoarthritis (OA) and its more severe subset erosive hand OA are common causes of pain and morbidity. Some metabolic factors were suggested to be implicated in erosive disease. Few studies investigated differences in systemic bone loss between erosive and non-erosive hand OA.Objectives:To compare the change of bone mineral density (BMD) between patients with erosive and non-erosive hand OA in a two-year longitudinal study.Methods:Consecutive patients with symptomatic HOA fulfilling the American College of Rheumatology (ACR) criteria were included in this study. Erosive hand OA was defined by at least one erosive interphalangeal joint. All patients underwent clinical assessments of joint swelling and radiographs of both hands. DEXA examination of lumbar spine, total femur and femur neck was performed at the baseline and after two years.Results:Altogether, 141patients (15 male) with symptomatic nodal HOA were included in this study and followed between April 2012 and January 2019. Out of these patients, 80 had erosive disease after two years. The disease duration (p<0.01) was significantly higher in patients with erosive compared with non-erosive disease at baseline.Osteoporosis (T-score <-2.5 SD) was diagnosed in 12.5% (9/72) of patients with erosive hand OA and in 8.06% (5/57) of patients with non-erosive hand OA at baseline. BMD was significantly lowered in patients with erosive compared with non-erosive disease at baseline (lumbar spine: 1.05g/cm2 vs. 1.13 g/cm2, p<0.05, total femur: 0.90 g/cm2 vs. 0.97 g/cm2, p<0.01 and femur neck: 0.86 g/cm2 vs. 0.91, p<0.05). T-scores of lumbar spine (-0.96 vs. -0.41 SD, p<0.05), total femur (-0.69 vs. -0.33 SD, p<0.05) and femur neck (-1.14 vs. -0.88 SD, p<0.05) were also significantly lowered in patients with erosive compared with non-erosive disease.Two years, the BMD remained also significantly lowered in patients with erosive compared with non-erosive disease (lumbar spine: 1.05g/cm2 vs. 1.14 g/cm2, p<0.05, total femur: 0.92 g/cm2 vs. 0.97 g/cm2, p<0.05 and femur neck: 0.86 g/cm2 vs. 0.91, p<0.05), which was in agreement with the finding for T-scores of lumbar spine (-1.05 vs. -0.39 SD, p<0.05), total femur (-0.74 vs. -0.34 SD, p<0.01) and femur neck (-1.07 vs. -0.72 SD, p<0.01).Conclusion:These results suggest that patients with erosive hand OA are at higher risk for the development of general bone loss. Over two years patients with erosive disease had significant lower bone mineral density at all measured sites.References:[1]This work was supported by the project AZV no. 18-00542 and MHCR No. 023728.Acknowledgments:Project AZV no. 18-00542 and MHCR No. 023728Disclosure of Interests:Karel Pavelka Consultant of: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Speakers bureau: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Ladislav Šenolt: None declared, Olga Sleglova: None declared, Jiří Baloun: None declared, Olga Růžičková: None declared

Severity of liver disease does not predict osteopenia or low bone mineral density in primary sclerosing cholangitis

2005 ◽  
Vol 25 (2) ◽  
pp. 311-316 ◽  
Author(s):  
Mical S. Campbell ◽  
Gary R. Lichtenstein ◽  
Andrew D. Rhim ◽  
Michael Pazianas ◽  
Thomas Faust
Keyword(s):  
Bone Mineral Density ◽  
Liver Disease ◽  
Primary Sclerosing Cholangitis ◽  
Bone Mineral ◽  
Sclerosing Cholangitis ◽  
Mineral Density ◽  
Low Bone Mineral Density

Ovarian Failure After Adjuvant Chemotherapy Is Associated With Rapid Bone Loss in Women With Early-Stage Breast Cancer

2001 ◽  
Vol 19 (14) ◽  
pp. 3306-3311 ◽  
Author(s):  
Charles L. Shapiro ◽  
Judith Manola ◽  
Meryl Leboff
Keyword(s):  
Breast Cancer ◽  
Bone Mineral Density ◽  
Alkaline Phosphatase ◽  
Adjuvant Chemotherapy ◽  
Bone Loss ◽  
Bone Mineral ◽  
Ovarian Failure ◽  
Mineral Density ◽  
Specific Alkaline Phosphatase ◽  
Bone Specific Alkaline Phosphatase

PURPOSE: We sought to evaluate the effects of chemotherapy-induced ovarian failure on bone loss and markers of skeletal turnover in a prospective longitudinal study of young women with breast cancer receiving adjuvant chemotherapy. PATIENTS AND METHODS: Forty-nine premenopausal women with stage I/II breast cancers receiving adjuvant chemotherapy were evaluated within 4 weeks of starting chemotherapy (baseline), and 6 and 12 months after starting chemotherapy with dual-energy absorptiometry and markers of skeletal turnover osteocalcin and bone-specific alkaline phosphatase. Chemotherapy-induced ovarian failure was defined as a negative pregnancy test, greater than 3 months of amenorrhea, and a follicle-stimulating hormone ≥ 30 MIU/mL at the 12-month evaluation. RESULTS: Among the 35 women who were defined as having ovarian failure, highly significant bone loss was observed in the lumbar spine by 6 months and increased further at 12 months. The median percentage decrease of bone mineral density in the spine from 0 to 6 months and 6 to 12 months was −4.0 (range, −10.4 to +1.0; P = .0001) and −3.7 (range, −10.1 to 9.2; P = .0001), respectively. In contrast, there were no significant decreases in bone mineral density in the 14 patients who retained ovarian function. Serum osteocalcin and bone specific alkaline phosphatase, markers of skeletal turnover, increased significantly in the women who developed ovarian failure. CONCLUSION: Chemotherapy-induced ovarian failure causes rapid and highly significant bone loss in the spine. This may have implications for long-term breast cancer survivors who may be at higher risk for osteopenia, and subsequently osteoporosis. Women with breast cancer who develop chemotherapy-induced ovarian failure should have their bone density monitored and treatments to attenuate bone loss should be evaluated.

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