Home Bratislava Medical Journal 2014 Bratislava Medical Journal Vol.115, No.9, p.573-578, 2014

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Published Monthly, in English
Founded: 1919
ISSN 0006-9248
(E)ISSN 1336-0345

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Bratislava Medical Journal Vol.115, No.9, p.573-578, 2014

Title: Vitamin D status, bone metabolism and bone mass in patients with alcoholic liver cirrhosis
Author: Z. Savic, D. Damjanov, N. Curic, B. Kovacev-Zavisic, L. Hadnadjev, J. Novakovic-Paro, S. Nikolic

Abstract:

Introduction: Osteoporosis is seen in some 12–50 % patients with liver cirrhosis. Detrimental effects of alcohol are exerted directly on the bone cells and indirectly on hormones. Vitamin D is involved in osteoblast differentiation, bone matrix synthesis and bone mineralization, as well as in its decomposition. Vitamin D deficiency has been reported in about 2/3 patients with liver cirrhosis.
Objective: Determination of vitamin D status, bone metabolic activity and bone mass in patients with alcoholic liver cirrhosis (ALC).
Methods: Thirty male patients with ALC were investigated in the period October 2011– March 2012. Total vitamin D, parathormone, osteocalcin and CrossLaps were determined by the ECLIA method (electrochemiluminiscence immunoassay) using Elecsys 2010 analyzer. Bone mineral density was measured by means of dual-energy x-ray absorptiometry (DXA) using the Lunar Prodigy. Result analysis was performed using descriptive statistics and hypothesis testing, as well as nonparametric one-way analysis of variance, Kruskal-Wallis test, Mann-Whitney U-test, Pearson correlation coefficient.


Results: Deficiency in vitamin D (< 50 nmol/l) was noted in 66.66 % patients, with highest prevalence in Child-Pugh C class patients (chi-square = 5.878, p < 0.05).

Osteocalcin levels were below the lower limit of normal in 86.7 % patients. CrossLaps was increased in only 20 % patients, but a significant increase was noted in Child-Pugh C class patients. Osteoporosis was diagnosed in 20 % of patients, with no correlation with disease severity and vitamin D status.
Conclusions: Vitamin D deficiency is present in patients with ALC. Decrease in bone formation and bone mass is most probably multicausal (Tab. 2, Fig. 1, Ref. 30).



Keywords: alcoholic liver cirrhosis, vitamin D, bone metabolism, bone mass.
Year: 2014, Volume: 115, Issue: 9 Page From: 573, Page To: 578
doi:10.4149/BLL_2014_111


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