Hepatic Osteodystrophy: Prevalence and Correlation with Aetiology and Functional Class

Abstract

Introduction: Metabolic bone disease occurring in chronic liver disease (CLD) is known as hepatic osteodystrophy (HOD) and treatment of which can reduce the morbidity and fracture risk. This study aims to investigate the prevalence of HOD and correlate it with child (CTP) status of liver disease and Model for End Stage Liver Disease (MELD). Method: This was a cross-sectional study conducted in AIMS, Kochi between October 2013 and March 2015, in which 136 patients with chronic liver disease of any etiology were included. Osteoporosis was evaluated by dual energy X-ray absorptiometry (DEXA) and bone mineral density (BMD) was measured in Lumbar spine (L1–L4) and femur. Osteodystrophy was defined by World Health Organization criteria. The baseline and relevant clinical data including Vitamin D3 levels were recorded on a predesigned proforma and correlated with HOD using SPSS version 16.0. Result: Mean age of the population was 50.84 years with a male preponderance (n = 129). The mean duration of liver disease was 23.3 19.2 months and alcohol being the most common etiology (55%) with a majority of patients having decompensated liver disease (53.7%). The overall prevalence of osteodystrophywas77.9% (42.6%osteopenia and35.3%osteoporosis). The mean T-score was ( 1.735) (1.505). Lumbar spine was more affected than femur. Osteoporosis was more common in patients with CHILD C cirrhosis (46.6%) (P 20), irrespective of etiology and vitamin D levels. Conclusion: Our study showed high prevalence of HOD in patients with CLD which was more common in advanced liver disease irrespective of etiology or vitamin D levels. Further studies with relevant clinical outcomes are therefore warranted in order to guide therapeutic decisions in this population. Corresponding author: Harikumar Nair. E-mail: harikumnair@yahoo.co.in