NEW YORK (Reuters Health) – Individuals with chronic liver disease have a higher rate of bone loss at the femoral neck than do those without liver disease, Swedish researchers report. The investigators also found that hyperbilirubinemia and low vitamin D3 levels are predictors of bone loss in these patients.
Dr. Sif Ormarsdףttir and colleagues, from University Hospital, Uppsala, measured bone mineral density (BMD) in 43 men and women with chronic liver disease. At baseline and after about 2 years, BMD measurements were taken at the lumbar spine and femoral neck.
Over a median of 25 months between measurements, mean annual bone loss in women was 0.63% at the lumbar spine and 1.5% at the femoral neck. For men, mean annual bone loss was 0.76% at the lumbar spine and 2.90% at the femoral neck, according to the report in the January issue of the European Journal of Gastroenterology & Hepatology.
Over time, BMD Z scores decreased significantly at the femoral neck in both men (p = 0.02) and women (p = 0.005). In patients classified as Child-Pugh B + C, bone loss at the lumbar spine significantly increased compared with patients classified as Child-Pugh A (p = 0.04), the Swedish team found.
Dr. Ormarsdףttir's group also found that increased bilirubin levels were an independent predictor of bone loss at the femoral neck (p = 0.003), as were decreased levels of 25-hydroxy vitamin D3 (p = 0.03).
"Patients with chronic liver disease and well-preserved liver function do not lose bone at a higher rate than expected at the lumbar spine, while increased bone loss was observed at the femoral neck, mainly in male patients," Dr. Ormarsdףttir and colleagues conclude.