Bone Mineral Density Assessment in Chronic Liver Disease

Prem kumar K, K. Narayanasamy, Janifer Jasmine J, C. A, Senthil Kumar R
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引用次数: 3

Abstract

Aim: The present study was aimed at estimating the prevalence of osteoporosis, symptoms, etiology, factors influencing the osteoporosis in patients with liver complications and to study the association of osteoporosis and severity of liver dysfunction and impact of osteoporosis on quality of life. Methods: 90 eligible patients tested in Rajiv Gandhi Government General Hospital. Patient’s samples were collected, tested and results recorded. Results: Out of 90 patients (M-84.4%, F-15.6%) and as age progressed, osteopenia and osteoporosis found than the normal patients. Higher percentage of patients had Fatigue symptoms. Common etiology was HBV. As the Child-Pugh-Turcotte (CTP) scoring was increased from A to C the numbers of patients were increased from normal to osteopenia followed by osteoporosis. Statistical significance was found between Normal and Low Bone Marrow Density (BMD) with Model for end-stage liver disease (MELD), Vitamin-D, Para-thyroid hormone and Duration of diseases. Statistical significant found between Normal and Low BMD in the elevation biological markers like T. bilirubin, AST, ALT, SAP (females) and Albumin. Conclusion: Among the liver diseases patients ¾ of them were with Low BMD. Linear progression of low BMD was found with increased age. With the symptom also we can detect low BMD in liver diseases patients. As the CTP increased low BMD was observed. Alcoholic liver disease had highest proportion of osteoporosis. Routine testing of vitamin D in HBV patients, higher MELD and increased duration of liver diseases will guide us for better and early diagnosis of low BMD among the liver diseases population.
慢性肝病的骨密度评估
目的:了解肝合并症患者骨质疏松的患病率、症状、病因、影响骨质疏松的因素,探讨骨质疏松与肝功能障碍严重程度的关系及骨质疏松对生活质量的影响。方法:在拉吉夫甘地政府总医院对90例符合条件的患者进行检测。收集患者样本,进行检测并记录结果。结果:90例患者(M-84.4%, F-15.6%)中,随着年龄的增长,骨质疏松和骨质减少的发生率明显高于正常患者。有疲劳症状的患者比例较高。常见病因为HBV。随着Child-Pugh-Turcotte (CTP)评分从A增加到C,患者数量从正常增加到骨质减少,随后骨质疏松。正常和低骨密度(BMD)与终末期肝病模型(MELD)、维生素d、甲状旁腺激素、病程之间的差异均有统计学意义。正常骨密度与低骨密度在T.胆红素、AST、ALT、SAP(女性)、白蛋白等生物标志物升高方面有统计学意义。结论:肝病患者中有3 / 4为低骨密度。低骨密度随年龄增长呈线性发展。该症状还可用于肝病患者的低骨密度检测。随着CTP的增加,骨密度降低。酒精性肝病中骨质疏松的比例最高。常规检测HBV患者的维生素D、较高的MELD和肝病持续时间的增加将指导我们更好地和早期诊断肝病人群的低骨密度。
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