Bone Mineral Density in Patients With Cirrhosis of Liver Awaiting Liver Transplantation

Abstract

Background and Aim: There is association between cirrhosis and low bone mineral density (BMD) and limited data regarding prevalence of low BMD in patients awaiting liver transplantation in India. Aim of this study is to determine the prevalence of low BMD and factors associated with it in Indian patients with cirrhosis awaiting liver transplantation. Methods: Patients with Child–Turcotte–Pugh (CTP) class B or C cirrhosis awaiting liver transplantation who fulfilled the inclusion criteria were included in study. BMD measurement at lumbar spine and femoral neck were obtained by Dual Energy X-ray Absorptiometry (DXA). Prevalence of low BMD (defined as T score below −1) among the study population was determined by using Hologic DXA database (Caucasian reference standards) and newly generated ICMR database. Results: Study group comprised of 100 Indian cirrhotic patients awaiting transplantation (79 males). Mean age was 51.2 + 9.7 years with most common etiology of cirrhosis was alcohol (36%). Cirrhosis was CTP class B in 42% and class C in 58%. By using Hologic DXA database and ICMR database prevalence of low BMD was 82% (osteopenia 42% and osteoporosis 40%) and 62% (osteopenia in 43%; osteoporosis in 19%), respectively. Low BMD prevalence was high at the lumbar spine (82%) compared to femoral neck (54%) (P < 0.05). Conclusion: Present study revealed high prevalence of low BMD in Indian patients with cirrhosis awaiting liver transplantation using both database. To decrease complications, correction of osteopenia and osteoporosis in cirrhotic patients should be considered, for which further studies are required. The authors have none to declare.