scholarly journals Assessment of Bone Mineral Density in Nonalcoholic Steatohepatitis Cirrhosis

2019 ◽  
Vol 21 (1) ◽  
pp. 16-20
Author(s):  
Afroza Begum ◽  
Sadia Sultana ◽  
Shahnaz Begum ◽  
Pupree Mutsuddy
Keyword(s):  
Bone Mineral Density ◽  
Liver Disease ◽  
Bone Mineral ◽  
Nonalcoholic Steatohepatitis ◽  
Mineral Density ◽  
Female Ratio ◽  
X Ray ◽  
Hepatic Osteodystrophy ◽  
Cirrhotic Patients ◽  
Cirrhotic Group

Background: Cirrhosis is characterized by diffused hepatic fibrosis and nodule formation that can occur at any age. It has significant morbidity and mortality. Worldwide common causes of cirrhosis are viral hepatitis (hepatitis B virus and hepatitis C virus), prolonged excessive alcohol intake and nonalcoholic fatty liver disease (NAFLD). Progression of chronic liver disease (CLD) and deterioration of liver function are associated with various hepatic complications. Hepatic osteodystrophy is an important extrahepatic manifestation of advanced liver disease with features of classical osteoporosis and an increased risk for fractures. The objective of the study to assess the bone mineral density (BMD) by duel energy x-ray absorptiometry (DEXA) in patients with nonalcoholic steatohepatitis (NASH) cirrhosis of liver.  Patients and Methods: A cross sectional observational study was carried out at National Institute of Nuclear Medicine and Allied Sciences (NINMAS), Bangabandhu Sheikh Mujib Medical University (BSMMU) campus, Dhaka, from July, 2016 to June, 2017. This study included the diagnosed cases of NASH cirrhosis patients presented at outpatient or inpatient department of Hepatology of BSMMU. For measurement of the BMD dual energy x-ray absorptiometry (DEXA) scan was performed by DMS Strator DR Bone densitometer at NINMAS.  BMD were measured at lumbar vertebrae L1-L4 and both the femoral neck. Analysis of data from DEXA was computerized and completely automated (software 3DXA, Medix DR.)   Results: A total of 54 participants was included and among them 27 were cirrhotic patients (cirrhotic group) & 27 were non-cirrhotic patients with healthy liver (non-cirrhotic group). The age range of the patients was 40-70 years in both groups. Male to female ratio was 1:1.45.  The mean age was 56.3 ± 6.7 years in cirrhotic group and 55.0 ± 6.3 years in non cirrhotic group. In cirrhotic group, 22 (66.7%) patients had low BMD and five (23.8%) patients had normal BMD. In non-cirrhotic group, 11 (33.3%) patients had low BMD and 16 (76.2%) patients had normal BMD. The difference was statistically significant (p < 0.05) between two groups. Multivariate logistic regression analysis was done to see the effect of multiple independent variables (age, menopause and cirrhosis) on dependent variable (low BMD). In cirrhotic patients odds ratio (OR) was 1.961 (95% CI 0.110 to 25.893) which implies cirrhotic patients had 1.961 times greater chance to develop low BMD than non cirrhotic patients keeping all other factors in fixed level.  Conclusion: Hepatic osteodystrophy is an important extrahepatic complication of cirrhosis. NASH cirrhosis is found among elderly people and female. Osteoporosis is common in aged people and menopausal female. But in this study it was observed that a NASH cirrhosis patient is highly significant risk factor for low BMD (osteopenia and osteoporosis) other than aged persons and menopausal females. So, special measures and monitoring should be taken regarding osteoporosis in NASH cirrhotic patient to reduce subsequent morbidity. Bangladesh J. Nuclear Med. 21(1): 16-20, January 2018

scholarly journals Anxiety Levels Predict Bone Mineral Density in Postmenopausal Women Undergoing Oral Bisphosphonates: A Two-Year Follow-Up

2021 ◽  
Vol 18 (15) ◽  
pp. 8144
Author(s):  
Gabriella Martino ◽  
Federica Bellone ◽  
Carmelo M. Vicario ◽  
Agostino Gaudio ◽  
Andrea Caputo ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Rating Scale ◽  
Osteoporotic Fractures ◽  
Oral Bisphosphonates ◽  
Mineral Density ◽  
X Ray ◽  
Hamilton Anxiety Rating Scale ◽  
Anxiety Levels

Clinical psychological factors may predict medical diseases. Anxiety level has been associated with osteoporosis, but its role on bone mineral density (BMD) change is still unknown. This study aimed to investigate the association between anxiety levels and both adherence and treatment response to oral bisphosphonates (BPs) in postmenopausal osteoporosis. BMD and anxiety levels were evaluated trough dual-energy X-ray absorptiometry and the Hamilton Anxiety Rating Scale (HAM-A), respectively. Participants received weekly medication with alendronate or risedronate and were grouped according to the HAM-A scores into tertiles (HAM-A 3 > HAM-A 2 > HAM-A 1). After 24 months, BMD changes were different among the HAM-A tertiles. The median lumbar BMD change was significantly greater in both the HAM-A 2 and HAM-A 3 in comparison with the HAM-A 1. The same trend was observed for femoral BMD change. Adherence to BPs was >75% in 68% of patients in the HAM-A 1, 79% of patients in the HAM-A 2, and 89% of patients in the HAM-A 3 (p = 0.0014). After correcting for age, body mass index, depressive symptoms, and the 10-yr. probability of osteoporotic fractures, anxiety levels independently predicted lumbar BMD change (β = 0.3417, SE 0.145, p = 0.02). In conclusion, women with higher anxiety levels reported greater BMD improvement, highlighting that anxiety was associated with adherence and response to osteoporosis medical treatment, although further research on this topic is needed.

scholarly journals POS0045 LEAST SIGNIFICANT CHANGE IN BONE DENSITOMETRY IN PATIENTS WITH OBESITY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 227.2-228
Author(s):  
D. Claire ◽  
M. Geoffroy ◽  
L. Kanagaratnam ◽  
C. Isabelle ◽  
A. Hittinger ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
General Population ◽  
Bone Mineral ◽  
Bone Densitometry ◽  
Dual Energy ◽  
Mineral Density ◽  
Least Significant Change ◽  
X Ray ◽  
Significant Change

Background:Dual energy X-ray absoprtiometry is the reference method to mesure bone mineral density (1). Loss of bone mineral density is significant if it exceeds the least significant change. The threshold value used in general population is 0,03 g/cm2 (2). Patients with obesity are known for having a higher bone mineral density due to metabolism and physiopathology characteristics (3,4).Objectives:The aim of our study was to determine the least significant change in bone densitometry in patients with obesity.Methods:We conducted an interventionnal study in 120 patients with obesity who performed a bone densitometry. We measured twice the bone mineral density at the lumbar spine, the femoral neck and the total hip in the same time (5,6). We determined the least significant change in bone densitometry from each pair of measurements, using the Bland and Altman method. We also determined the least significant change in bone densitometry according to each stage of obesity.Results:The least significant change in bone densitometry in patients with obesity is 0,046g/cm2 at the lumbar spine, 0.069 g/cm2 at the femoral neck and 0.06 g/cm2 at the total hip.Conclusion:The least significant change in bone densitometry in patients with obesity is higher than in general population. These results may improve DXA interpretation in this specific population, and may personnalize their medical care.References:[1]Lees B, Stevenson JC. An evaluation of dual-energy X-ray absorptiometry and comparison with dual-photon absorptiometry. Osteoporos Int. mai 1992;2(3):146-52.[2]Briot K, Roux C, Thomas T, Blain H, Buchon D, Chapurlat R, et al. Actualisation 2018 des recommandations françaises du traitement de l’ostéoporose post-ménopausique. Rev Rhum. oct 2018;85(5):428-40.[3]Shapses SA, Pop LC, Wang Y. Obesity is a concern for bone health with aging. Nutr Res N Y N. mars 2017;39:1-13.[4]Savvidis C, Tournis S, Dede AD. Obesity and bone metabolism. Hormones. juin 2018;17(2):205-17.[5]Roux C, Garnero P, Thomas T, Sabatier J-P, Orcel P, Audran M, et al. Recommendations for monitoring antiresorptive therapies in postmenopausal osteoporosis. Jt Bone Spine Rev Rhum. janv 2005;72(1):26-31.[6]Ravaud P, Reny JL, Giraudeau B, Porcher R, Dougados M, Roux C. Individual smallest detectable difference in bone mineral density measurements. J Bone Miner Res. août 1999;14(8):1449-56.Disclosure of Interests: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

scholarly journals LOW BONE MINERAL DENSITY IN BRAZILIAN PATIENTS AT DIAGNOSIS OF CELIAC DISEASE

2015 ◽  
Vol 52 (3) ◽  
pp. 176-179 ◽  
Author(s):  
Joyce Timmermans Pires da SILVA ◽  
Renato M NISIHARA ◽  
Luís Roberto KOTZE ◽  
Márcia OLANDOSKI ◽  
Lorete Maria da Silva KOTZE
Keyword(s):  
Bone Mineral Density ◽  
Celiac Disease ◽  
Bone Mineral ◽  
Disease Diagnosis ◽  
Bone Fragility ◽  
Mineral Density ◽  
X Ray ◽  
Low Bone Mineral Density ◽  
Celiac Disease Diagnosis ◽  
Male Subjects

BackgroundLow bone mineral density is considered an extra-intestinal manifestation of celiac disease with reduced bone mass, increased bone fragility, and risk of fractures. Celiac disease is considered a condition at high risk for secondary osteoporosis and the evaluation of bone density is very important in the clinical management of these patients.ObjectiveThe present study aimed to investigate bone alterations in celiac patients from Curitiba, South Region of Brazil at diagnosis, correlating the findings with age and gender.MethodsPatients who were included in the study were attended to in a private office of the same physician from January 2009 to December 2013. The diagnosis of celiac disease was done through clinical, serological and histological findings. All data were collected from the medical charts of the patients. After the diagnosis of celiac disease, evaluation for low bone mineral density was requested by dual-energy X-ray absorptiometry (DEXA). DEXA bone densitometer was used to estimate low bone mineral density at the lumbar spine and femur.ResultsA total of 101 patients, 82 (81.2%) female and 19 (18.8%) male subjects, with mean age of 39.0±3.03 years were included. At celiac disease diagnosis, 36 (35.6%) were younger than 30 years, 41 (40.6%) were between 31 and 50 years, and 24 (23.8%) were older than 50 years. Among the evaluated patients, 69 (68.3%) presented low bone mineral density, being 47% with osteopenia and 32% with osteoporosis. Patients who were older than 51 years and diagnosed with celiac disease presented low bone mineral density in 83.3% (20/24) of the cases. As expected, age influenced significantly the low bone mineral density findings. Among women, low bone mineral density was present with high frequency (60%) from 30 to 50 years. In patients diagnosed older than 60 years (n=8), all the women (n=5) and two of the three men had osteoporosis.ConclusionThis study demonstrated that 69% of Brazilian patients with celiac disease at diagnosis had low bone mineral density, being more frequent in women older than 50 years.

Sign in / Sign up

Export Citation Format

Share Document