Abstract

INTRODUCTION: Chronic liver disease is a risk factor for osteoporosis, osteopenia and bone fractures. In this study, osteoporosis prevalence, risk factors, vitamin D deficiency and effects on survival were investigated in 218 chronic liver disease Turkish patients awaiting liver transplantation retrospectively. 

METHODS: Risk factors for osteoporosis (gender, age, BMI, etiology, smoking, alcohol use), serum bilirubin, albumin, 25-hydroxy (OH)D, parathyroid hormone levels, bone mineral density (BMD) with DEXA, MELD and Child Pugh(CP) scores were recorded. Effects of vitamin D levels and BMD on survival were evaluated. 

RESULTS: 147 (67.4%) patients were female (mean age, 50.4±11.7). Data of the BMD were established in 218 patients and 25-OH D levels in 122 patients. Mean serum 25-OH D level was 14.26±9.44 ng/ml. Osteoporosis was identified in 42 (19.3%) and osteopenia in 115 (52.8%) patients according to BMD (table 1). No statistically difference was found including risk factors, etiology, BMI, CP classification, MELD, albumin, total bilirubin, Ca, PTH between osteoporotic and non-osteoporotic patients. Patients were followed-up for median 30.07±11.83 months after BMD measurement. 54 (24.8%) died during the follow-up period, non of them related bone fracture. There is no statistically difference on survival between osteoporosis group (32.2±2.3 months) and non-osteoporosis group (37.2±1.7 months; p=0.26) (figure1) or between deficieny of vitamin D groups (table 2). 

CONCLUSION: The prevalence of osteoporosis and osteopenia were consistent with the prevalence of osteoporosis reported 12-55% in the literature. Although we didn’t identify any factors that statistically influence the relationship between survival and osteoporosis, cirrhotic patients should be screened for osteoporosis and vitamin D deficiency and treated appropriately.