TY - JOUR
T1 - Osteopenia and osteoporosis in patients with end-stage liver disease caused by hepatitis C and alcoholic liver disease
T2 - Not just a cholestatic problem
AU - Carey, Elizabeth J.
AU - Balan, Vijayan
AU - Kremers, Walter K.
AU - Hay, J. Eileen
N1 - Funding Information:
A total of 841 patients underwent 928 OLTs at the Mayo Clinic, Rochcstcr, MN, bctwccn January 1991 and Scptcm-bet 2001. All adult recipients undergoing primary liver transplantation with a single cadaver organ were reviewed to identify patients with HCV, ALD, and HCV+ALD. The study was approved by the Mayo Foundation Institutional Review Board.
PY - 2003/11
Y1 - 2003/11
N2 - Although best characterized in chronic cholestatic liver disease, osteopenic bone disease and fracturing are well-recognized complications of cirrhosis, particularly after liver transplantation. We sought to compare the prevalence of osteopenia and osteoporosis, to assess the effect of orthotopic liver transplantation (OLT) on bone density, and to determine fracture rates before and after OLT in three groups of patients with advanced cirrhosis: patients with cirrhosis from hepatitis C virus (HCV) alone, from alcohol abuse (ALD), and from HCV in conjunction with alcohol abuse (HCV+ALD). Between 1991 and 2001, 207 consecutive patients who underwent OLT for HCV (68 patients), ALD (66), and HCV+ALD (73) were assessed clinically, biochemically, radiologically, and by bone densitometry. The baseline mean T score was lower in the HCV group than in the ALD group (-1.43 versus -0.87, P = .048) despite ALD patients having more advanced liver disease; patients with HCV+ALD had intermediate T scores. The pattern of significant bone loss at 4 months and 12 months was similar for all three groups. The baseline fracture rate was lowest in the HCV group and highest in the ALD group, despite the latter having the highest bone density. Fractures occurred in 17% of patients in the first year after transplantation, the majority being vertebral compression fractures. Patients with cirrhosis caused by HCV, ALD, or a combination of both should be screened for osteopenia, especially before OLT.
AB - Although best characterized in chronic cholestatic liver disease, osteopenic bone disease and fracturing are well-recognized complications of cirrhosis, particularly after liver transplantation. We sought to compare the prevalence of osteopenia and osteoporosis, to assess the effect of orthotopic liver transplantation (OLT) on bone density, and to determine fracture rates before and after OLT in three groups of patients with advanced cirrhosis: patients with cirrhosis from hepatitis C virus (HCV) alone, from alcohol abuse (ALD), and from HCV in conjunction with alcohol abuse (HCV+ALD). Between 1991 and 2001, 207 consecutive patients who underwent OLT for HCV (68 patients), ALD (66), and HCV+ALD (73) were assessed clinically, biochemically, radiologically, and by bone densitometry. The baseline mean T score was lower in the HCV group than in the ALD group (-1.43 versus -0.87, P = .048) despite ALD patients having more advanced liver disease; patients with HCV+ALD had intermediate T scores. The pattern of significant bone loss at 4 months and 12 months was similar for all three groups. The baseline fracture rate was lowest in the HCV group and highest in the ALD group, despite the latter having the highest bone density. Fractures occurred in 17% of patients in the first year after transplantation, the majority being vertebral compression fractures. Patients with cirrhosis caused by HCV, ALD, or a combination of both should be screened for osteopenia, especially before OLT.
UR - http://www.scopus.com/inward/record.url?scp=0242624558&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0242624558&partnerID=8YFLogxK
U2 - 10.1053/jlts.2003.50242
DO - 10.1053/jlts.2003.50242
M3 - Article
C2 - 14586877
AN - SCOPUS:0242624558
SN - 1527-6465
VL - 9
SP - 1166
EP - 1173
JO - Liver Transplantation
JF - Liver Transplantation
IS - 11
ER -