Abstract
Osteoporosis is one of the major complications in chronic hepatitis B virus (HBV) and hepatitis C (HCV) infection. However, few studies had examined the relationship between hepatic viral infection with bone loss. Our aim was to investigate the association between hepatic viral infection with bone mineral density (BMD) in a cross-sectional study. Participants who attended the health examinations at the Tri-Service General Hospital (TSGH), Taiwan, were enrolled in the study. Diagnosis of viral hepatitis was confirmed by the serum viral markers of hepatitis B surface antigen (HBsAg) and anti-HCV, and BMD measurement was performed by the bone densitometry. Subjects were divided into four groups by the presence of viral markers. The association between hepatic viral infection and BMD was examined by a multivariate linear regression model. HBV infection was inversely associated with BMD after full adjusting with β values of −0.17 (95% CI: −0.29, −0.05) (p < 0.05). The relationship remained significant in males (β = −0.16, 95% CI = −0.31, −0.01) (p < 0.05). In subjects with body mass index less than 30 HBV infection was associated with reduced BMD (β = −0.16, 95% CI = −0.29, −0.02) (p < 0.05). However, HCV infection was only associated with an increase in BMD in patients with BMI less than 30 (β = 0.17, 95% CI = 0.21, 0.32) (p < 0.05). Chronic HBV infection was significantly associated with reduced BMD in males. The impact of viral hepatitis on bone health deserves further investigation for the potential pathophysiological mechanisms.
Highlights
The aim of the current study was to determine the association between hepatic viral infection and bone health
Our study was the first to examine the associations between different viral hepatitis with bone mineral density (BMD) in a large population-based analysis composed of Taiwanese adults
Huang et al demonstrated that chronic hepatitis B virus (HBV) infection were associated with low BMD and increased risk of developing subsequent osteoporosis in a case-control study composed of 148 patients[11]
Summary
After categorizing subjects into gender difference (Table 3), the relationship remained significant in males but not females. Those with HCV/HBV co-infection (β = −0.45, 95% CI = −0.86, −0.04) (p < 0.05) were more closely associated with reduced BMD than HBV infection (β = −0.16, 95% CI = −0.31, −0.01) (p < 0.05). Non-obesity subjects with HBV infection remained significant among this inverse relationship (β = −0.16, 95% CI = −0.29, −0.02) (p < 0.05). Non-obesity subjects with HCV infection had association with increased BMD in fully-adjusted model with β values of 0.17 (95% CI = 0.02, 0.32) (p < 0.05).
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