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Joint Bone Spine
Volume 78, n° 4
pages 387-391 (juillet 2011)
Doi : 10.1016/j.jbspin.2011.03.001
accepted : 26 October 2010
Assessing bone status in patients awaiting liver transplantation
 

Cécile Wibaux a, , Isabelle Legroux-Gerot a, Sébastien Dharancy b, Emmanuel Boleslawski b, Nicole Declerck b, Valérie Canva b, Philippe Mathurin b, François-René Pruvot b, Bernard Cortet a
a Service de rhumatologie, département universitaire de rhumatologie, université Nord de France, hôpital Roger-Salengro, CHRU de Lille, Lille, France 
b Service de transplantation hépatique, hôpital Claude-Huriez, CHRU de Lille, Lille, France 

Corresponding author.
Abstract

Osteoporosis is common in liver transplant recipients as a result of both iatrogenic factors and preexisting hepatic osteodystrophy.

Objectives

To assess the prevalences of osteoporosis and fractures and to identify risk factors for these two abnormalities in patients awaiting liver transplantation for end-stage liver disease.

Methods

Between January 2006 and December 2007, patients on a liver transplant waiting list underwent a routine evaluation comprising the identification of risk factors for osteoporosis, radiographs of the spine, bone mineral density measurements (BMD), and laboratory tests (phosphate and calcium levels, hormone assays, liver function tests, and bone turnover markers).

Results

We studied 99 patients (70 males and 20 females; mean age, 55±8years) including 75% with alcohol-induced cirrhosis with or without hepatocarcinoma. Among them, 36% had radiographic vertebral fractures, 38% had osteoporosis, 35% had osteopenia, and 88% had vitamin D insufficiency or deficiency (25(OH)vitamin D3<20 ng/mL). Lower BMD values were associated with vertebral fractures; the odds ratios and 95% confidence intervals for each BMD decrease of 1 SD were as follows: spine, 1.45 (95%CI, 1.1–1.9); total hip, 2.1 (95%CI, 1.3–3.2); and femoral neck, 2 (95%CI, 1.3–3.1) (P <0.05). Levels of bone resorption markers correlated negatively with BMD at the spine and hip. The Model for End-Stage Liver Disease score correlated negatively with hip BMD.

Conclusion

Our findings suggest high prevalences of low BMD values and vertebral fractures among patients awaiting liver transplantation. Bone status should be evaluated routinely in candidates to liver transplantation.

The full text of this article is available in PDF format.

Keywords : Osteoporosis, Fracture, Chronic liver disease, Transplantation




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