Osteoporosis in cirrhotics before and after liver transplantation: relation with malnutrition and inflammatory status.

This study aimed to in LT candidates investigate the potential relation between bone mineral density (BMD) and BMD loss in those who undergo LT, with malnutrition, systemic inflammation, and hormonal status.Methods: We included 102 consecutively recruited cirrhotic LT candidates between May 2004 and April 2007. BMD was assessed by means of dual energy X-ray absorptiometry (DXA). Malnutrition was defined by means of anthropometry and assessment of recent weight loss. In 75/102 patients, serum-thyroid stimulating hormone (TSH), free triiodthyronine (T3) and free thyroxine (T4) and growth hormone (GH), cortisol, free testosterone, dehydroepiandrosterone sulfate, estradiol, interleukin-6, and tumor necrosis factor (TNF)-α was assessed. Overall 57/102 patients received a LT and 47/102 were followed for one year post-LT. At follow-up, nutritional status and BMD were assessed in all patients (n = 47) while 34/47 had available blood samples for analysis.Results: Forty (40%) LT- candidates had osteopenia or osteoporosis and 34 (38%) were malnourished. Malnutrition was associated with osteopenia/osteoporosis (odds ratio: 3.5, 95% CI 1.4, 9.9). Hip BMD Z-score decreased -0.25 (95% CI -0.41, -0.09) from baseline to one year post-LT. High baseline TNF-α correlated with a more marked decline in BMD (Partial correlation (r) = -0.47, p 
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research

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AbstractSummaryWe studied 112 treatment-na ïve chronic HCV patients without cirrhosis, and we found that, especially HCV+ postmenopausal women, they had lower TBS and BMD values than healthy controls. This suggests that HCV infection is an independent risk factor for osteoporosis, and therefore, screening for osteoporosis in postmenopausal HCV+ women should be considered.PurposeTo know whether patients in earlier stages of chronic HCV infection are at increased risk of developing low bone mass and bone microarchitectural changes and whether there is an association between bone metabolism and the severity of the liver ...
Source: Archives of Orthopaedic and Trauma Surgery - Category: Orthopaedics Source Type: research
Primary biliary cholangitis is a slowly progressive immune-mediated cholestatic disease that causes a destruction of the intrahepatic bile ducts and may lead to cirrhosis of the liver, end-stage liver disease, and the need for liver transplantation. The disease is among the most common reasons why adults require liver transplantation. The primary signs of the disease include the presence of antimitochondrial and antinuclear antibodies, elevated alkaline phosphatase, hyperbilirubinemia, hypercholesterolemia, and histologic features, such as intense inflammation with a florid duct lesion and hepatic fibrosis. The patient's q...
Source: Gastroenterology Nursing - Category: Nursing Tags: Features Source Type: research
AbstractPurpose of ReviewCholestatic liver disease, including primary biliary cholangitis and primary sclerosing cholangitis, can be associated with numerous extrahepatic complications. Of these, malnutrition can negatively impact quality of life in these patients. Achieving nutritional optimization in patients with cholestatic liver disease is an essential component in the overall management of the disease.Recent FindingsThrough various mechanisms, including abnormalities in bile acid metabolism, malabsorption, anorexia, and increased metabolic rate, chronic malnutrition in cholestatic liver disease can lead to vitamin, m...
Source: Current Hepatitis Reports - Category: Infectious Diseases Source Type: research
Conclusions: ALDH2 deficient subjects showed a significant decrease in average blood acetaldehyde level 20 minutes after alcohol consumption (from 0.91 mg/dL to 0.71 mg/dL, P value = 0.02) after receiving 28 days of the nutritional supplement. Acetaldehyde levels taken at 10 minutes and 40 minutes also showed a decrease, although they were not statistically significant. In addition, safety tests looking at liver function tests showed a decrease in aspartate transaminase and alanine transaminase liver proteins from 27.3 to 15.2 and 20.9 to 13.2, respectively, over the 28 days. The treatment was well tolerated and no signi...
Source: American Journal of Therapeutics - Category: Drugs & Pharmacology Tags: Original Investigation Source Type: research
In conclusion, with study of the frailty syndrome still in its infancy, frailty analysis remains a major challenge. It is a challenge that needs to be overcome in order to shed light on the multiple mechanisms involved in the pathogenesis of this syndrome. Although several mechanisms contribute to frailty, immune system alteration seems to play a central role: this syndrome is characterized by increased levels of pro-inflammatory markers and the resulting pro-inflammatory status can have negative effects on various organs. Future studies should aim to better clarify the immune system alteration in frailty, and seek to esta...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
To investigate the differences in bone mineral density between patients with liver cirrhosis and healthy control, and to analyze the risk factors of hepatic osteoporosis in patients with HBV related liver cirrhosis. A total of 189 patients with liver cirrhosis and 207 health controls were enrolled. The bone mineral density of lumbar spine and femoral neck was examined by dual energy X-ray absorptiometry. −2.0
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Osteoporosis is a skeletal disorder characterized by the degradation of bone resulting in increased risk of fracture. Bone mineral density (BMD) and trabecular bone score (TBS) derived from dual energy X-ray absorptiometry (DXA) scans are used to diagnose osteoporosis through measurement of the bone quantity and quality respectively. Osteoporosis is prevalent in 12-55% of patients with chronic liver disease. Ascites, an accumulation of transudative fluid in the peritoneal cavity, can complicate cirrhosis.
Source: Journal of Medical Imaging and Radiation Sciences - Category: Radiology Authors: Source Type: research
Conclusion Figure 4 shows that the 27 different molecular defects within the ALB so far reported to cause CAA are located in ten different exons (1, 3, 4, 5, 7, 8, 9, 10, 11, and 12) and in seven different introns (1, 2, 3, 6, 10, 11, and 12) (The Albumin Website, 2018; Caridi et al., 2019). Variations in the last two coding exons (13 and 14) would probably cause the presence of a circulating C-terminal variant of the protein and not CAA. The first twelve exons of ALB, with the exception of the two shortest, exons 2 and 6, were reported to contain at least one molecular defect resulting in CAA (The Albumin Website, 2018; ...
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
This study investigated the association between atrial conduction time and prolidase activity, a collagen synthesis enzyme, and P-wave dispersion (PWD) in patients with paroxysmal atrial fibrillation (PAF). METHODS: Exclusion criteria included age of
Source: Combinatorial Chemistry and High Throughput Screening - Category: Chemistry Authors: Tags: Comb Chem High Throughput Screen Source Type: research
ConclusionsHepatic cirrhosis deteriorates both trabecular and cortical microarchitecture, regardless of disease severity. Areal bone mineral density is diminished at all sites as a sign of generalized affection. In patients with hepatic cirrhosis, regardless of its origin or disease severity, aBMD measurements are an appropriate tool for osteologic screening.
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
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