Study of Clinical Profile of Metabolic Bone Diseases in Liver Cirrhosis in Central India

Abstract

Background and Aim: Metabolic bone disorders also known as hepatic osteodystrophy (HOD) are well-recognized extra hepatic complication of cirrhosis. There are very scanty data on the prevalence of metabolic bone disease in the Indian population. We aimed to determine the prevalence of metabolic bone disease in patients with liver cirrhosis and to study the factors associated with it along with impact of calcium and vitamin D on bone mineral density (BMD) in patients with liver cirrhosis. Methods: Consecutive patients with liver cirrhosis between the age group of 18–65 years presented to Department of Gastroenterology, between 1/12/2014 and 30/11/2015 were evaluated with inclusion and exclusion criteria and enrolled as study population. BMD was measured by dual-energy X-ray absorptiometry (DEXA) at the lumbar spine and total hip. Osteopenia and osteoporosis were defined according to WHO criteria. These patients were divided into three groups—normal bone mineral density, osteopenia and osteoporosis according to T score obtained by DEXA scan. All patient diagnosed to have osteoporosis and osteopenia was re-evaluated at end of 3 months of calcium and vitamin D supplementation with follow up BMD. Results: A total of 76 patients [males 67 (88.2%, female 9 (11.8%)] with a mean age of 49.90 ± 11.35 years were enrolled in this study. Prevalence of metabolic bone disease was found to be 71% (54/76). On statistical analysis, mean duration of symptoms of liver disease, BMI, platelet count, total serum bilirubin, mean CTP and MELD score were found to be statistically different in three groups of patients. There was no significant improvement/deterioration in the BMD in the osteopenia and osteoporosis groups after treatment with vitamin D and calcium. Conclusions: Prevalence of metabolic bone disease in liver cirrhosis patients in Central India is high (71%). Malnutrition in advance liver cirrhosis is important risk factor for metabolic bone disease. The authors have none to declare.