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Prevalence of hepatic osteodystrophy and vitamin D deficiency in cirrhosis.
Intern Med J. 2015 Aug 6;
Authors: Chinnaratha MA, Chaudhary S, Doogue M, McCormick RJ, Woodman RJ, Wigg AJ
Abstract
BACKGROUND: Hepatic osteodystrophy (HO) is a major complication of cirrhosis. However, the prevalence of HO in a general cirrhotic patient population is not well defined as previous studies were in single aetiology or pre-liver transplant patients.
AIMS: To investigate the prevalence of HO and vitamin D deficiency in patients with cirrhosis of mixed aetiology and disease severity and to determine the risk factors for HO.
METHODS: A single centre cross-sectional study of all patients newly diagnosed with cirrhosis between Sep 2009 and Dec 2012. All patients underwent Bone Mineral Density assessment using Dual Energy X-ray Absorptiometry within 3 months of diagnosis. Demographic and biochemical factors, severity of underlying liver disease, previous fragility fractures, smoking status and alcohol use were collected on diagnosis. Logistic regression analysis was used to assess risk factors for HO.
RESULTS: Among the 406 patients [67% males, median (range) age: 56(21-85) years], most (84%) were Childs-Pugh A or B with a median (range) MELD score of 11(5-40). Alcohol (41%) was the most common underlying aetiology. The prevalence of HO and vitamin D deficiency (≤50 nmol/L) was 56% and 54% respectively, and previous fragility fractures had occurred in 3%. Increasing age [OR (95%CI): 1.49 per 10years (1.02-2.18), p=0.04], excessive alcohol intake [2.34(1.03-5.32), p=0.04] and lower BMI [0.92 per kg/m(2) (0.87-0.98), p=0.009] were independent risk factors for HO.
CONCLUSIONS: There is a high prevalence of HO and vitamin D deficiency in patients with cirrhosis at presentation irrespective of disease severity or underlying aetiology.
PMID: 26247615 [PubMed - as supplied by publisher]