Assessment of Bone Disease in Cirrhosis of Liver

Abstract

Background and Aim: We attempted to study bone density, site of measurement, cutoff for screening and vitamin D deficiency in chronic liver disease. Methods: Bone density at the hip and spine, serum calcium and vitamin D measurements were performed on all newly diagnosed chronic liver disease patients after excluding females, renal failure and recent administration of calcium, Vitamin D, Corticosteroids and bisphosphonates. Results: Out of 107 patients, 37.4% had spinal osteoporosis while 9.3% had hip osteoporosis. According to Child Turcotte and Pugh severity score, spinal osteoporosis was found in 14.7% of class A, 42.5% of class B and 54.5% of class C patients. Receiver operating characteristic curves revealed a cutoff of Model for End Stage Liver Disease 12 for osteoporosis. Vitamin D deficiency was demonstrated in 50% of class A, 67.5% of class B patients and 90.9% of class C patients. Both vitamin D deficiency and osteoporosis correlated with disease severity but not with etiology. Spinal bone density measurements were found to be better. Cutoff of 12 of the model for end stage liver disease was found to reflect significant bone disease. Conclusion: Evaluation for bone disease should be mandatory for all cirrhotics above Model for end stage liver disease 12. The authors have none to declare.