Journals / Ege Tıp Dergisi / 2004 / Cilt: 43 - Sayı: 1

Change of bone metabolism in patients with hepatitis B virus induced chronic active hepatitis and cirrhosis

Hepatit B virüsüne bağlı (HBV) kronik aktif hepatit ve siroz sürecindeki hastalarda kemik metabolizması değişiklikleri

Pages
9–13
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

On ffie other hand, BAP and type 1 collagen propeptide levels were high only in cirrhosis group.In conclusion, contrary to expection we didn't found the presence of osteomalasia, but high turnover bone loss was displayed in both CAH and cirrhosis group.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:In this study, we evaluated 15 pts with cirrhosis and 14 pts with CAH due to HBV etiology. 20 healthy volunteers with similar age and sex were admited to study as control.
📊
Key Findings & Data:We measured the plasma ionised Ca, 25(OH)Vit D, PTH levels as a marker of bone mineralization; bone spesific alkaline phophatase (BAP), osteocalcin and type-1 collagen propeptide as the marker of bone formation; and urinary calcium and deoxypyridinoline excretion for determination of bone resorption.
💡
Conclusion & Impact:On ffie other hand, BAP and type 1 collagen propeptide levels were high only in cirrhosis group.In conclusion, contrary to expection we didn't found the presence of osteomalasia, but high turnover bone loss was displayed in both CAH and cirrhosis group.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Hepatit B virüsü · Hepatit · kronik

Abstract

In this study, we evaluated 15 pts with cirrhosis and 14 pts with CAH due to HBV etiology. 20 healthy volunteers with similar age and sex were admited to study as control. We measured the plasma ionised Ca, 25(OH)Vit D, PTH levels as a marker of bone mineralization; bone spesific alkaline phophatase (BAP), osteocalcin and type-1 collagen propeptide as the marker of bone formation; and urinary calcium and deoxypyridinoline excretion for determination of bone resorption. Bone mineral density of the lumbar spine and proximal part of femur was assesed by dual emission X-ray absorptiometry (DEXA) method. There was no statistically significant difference between cirrhosis, CAH and control groups for plasma ionised Ca, 25(OH)Vit D and PTH levels. Both in CAH and cirrhosis groups significantly increased bone loss were found by measurements of BMD of L1-L4 lumbar spine and 5 different areas of femur (neck, trochanter, intertrochanter, Ward's triangle and total). Plasma osteocalcin level was found significantly higher in both pts groups than controls (p<0.05). On ffie other hand, BAP and type 1 collagen propeptide levels were high only in cirrhosis group.In conclusion, contrary to expection we didn't found the presence of osteomalasia, but high turnover bone loss was displayed in both CAH and cirrhosis group.

Özet

Bu çalışmada, HBV'ne bağlı kronik aktif hepatit (KAH) ve sirozlu hastalarda kemik metabolizmasındaki değişiklikleri göstermek amacıyla, HBV'ne bağlı gelişmiş 14 KAH ve 15 siroz hastasında kemik mineralizasyonu belirleyicisi olarak plazma iyonize kalsiyum (Ca), 25 hidroksi vitamin D (25(OH)vitD), paratiroid hormon (PTH) seviyeleri; kemik yapımı belirleyicileri olarak, kemik spesifik alkelen fosfataz (KAP), osteokalsin (OK), tip-1 kolajen propeptid (T-1KP) ve yıkım parametreleri olarak idrarda Ca ve deoksipridinolin (DP) atılımı ile X-ray emisyon absorptiometre (DEXA) yöntemiyle lumbar vertebra ve femur proksimalinin kemik mineral dansiteleri (KMD) çalışıldı. Benzer yaş ve cinsten 20 sağlıklı gönüllü kişi kontrol grubu olarak çalışmaya katıldı. KAH, siroz ve kontrol grubunda plazma iyonize Ca, 25(OH)vitD ve PTH düzeyleri anlamlı bir farklılık göstermedi. L1-L4 vertebra ve femurun değerlendirilen 5 bölgesinde (boyun, trokanter, intertrokanter, Ward's üçgeni, total) her iki hasta grubunda kontrol grubuna göre kemik kitlesinde belirgin kayıp olduğu gösterildi. Plazma OK düzeyinde her iki hasta grubunda kontrole göre istatistiksel olarak anlamlı artış saptandı. Buna karşılık KAP ve T-1KP düzeyleri sadece sirotik evredeki hastalarda kontrollere göre anlamlı yüksek bulundu. Sonuç olarak, beklenenin aksine HBV'ne bağlı gelişen KAH ve siroz hastalarının hiçbirinde osteomalazik bir tablo saptanmazken, her iki hasta grubunda yüksek dönüşüm hızlı osteopeni ve osteoporoz varlığı belirlendi.

🔖

Cite This Article

VURAL, F., BAYRAKTAR, M. (2004). Change of bone metabolism in patients with hepatitis B virus induced chronic active hepatitis and cirrhosis. Ege Tıp Dergisi, Cilt: 43 - Sayı: 1, 9–13. https://ajindex.com/articles/222988

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (17)

  1. Solorio E, Isaia G, Innarella R et al. Osteoporosis, still a typical complication of primary biliary cirrhosis? Dig Liver Dis 2003; 35(5);339-46
  2. Carey E, balan V. Metabolic bone disease in patients with liver disease. Curr Gastroenterol Rep 2003; 5;71-7
  3. Newton J, Jones D. Osteoporosis in primary biliary cirrhosis. Panminerva Med 2002; 44;335-41
  4. Hodgson SF, D􀃕 ckson ER, Eastell R et al. Rates of cancellous bone remodeling and turnover in osteopenia associated with primary biliary cirrhosis. Bone 1993;14;819-27
  5. Guanabens N, Pares A, Marinoso L, et al. Factors influencing the development of metabolic bone disease in primary biliary cirrhosis. Am J Gatroenterol 1990; 85:1356-62
  6. Rosen H. Primary biliary cirrhosis and bone disease. Hepatol 1995; 21;253-5
  7. Diamond T, Stiel D, Mason R, et al. Serum vitamin D metabolites are not responsible for low turnover osteoporosis in chronic liver disease. J Clin. Endocrinol Met 1987; 69: 1234-9
  8. Imavvari M, Akanuma Y, Itakura H, et al.The effects of disease of the liver on serum 25-hyroxyvitamin D and on the serum binding protein for vitamin D and its metabolites. J Lab Clin Med 1979; 93:171-80
  9. Bouillon R, Auwerx JA, Fevery J et al. Serum vitamin D metabolites and their binding proteins in patients with liver cirrhosis. J Clin Endocrinol Met 1984; 59:86-90
  10. Compston C. Hepatic osteodystrophy: Vitamin D metabolism in patients with liver disease. Gut 1986; 27:1073-9 11. Van Berkum FNR, Beukers R, et al. Bone mass in women with primary biliary cirrhosis: the 12. relation with histological stage and use of glucocorticoids. Gastroenterol 1990; 99:1134-9
  11. Lopes MB, Pinto G, Havvkins F, et al. Effect of liver transplantation and immunosuppresive treatment on bone mineral density. Trans. Proceed 1992; 24: 3044-6
  12. Fonceca V, Epstein O, Gill S, et al. Hyperparathyroidism and low serum osteocalcin, vitamin D replacement in primary biliary cirrhosis. J Clin Endocrinol Met 1987; 64: 873-7
  13. Hay JE. Bone disease in cholestatic liver disease. Gastroenterol 1995; 108:276-83
  14. McCarrroll, NA. Bone disorders (osteoporosis). Clin Chem 1993; 65:388-94
  15. Long RG, Meinhard E, Sk􀃕 nner RK, et al. Clinical biochemical and histological studies of osteomalacia, osteoporosis and parathyroid function in chronic liver disease. Gut 1978; 19;85-9
  16. Diamond T, Stiel D, Lunzer M, et al. Hepatic osteodystrophy. Gastroenterol 1989; 96:213-21
  17. Cuthbert JA, Pak C, Zerwekh JE, Combes B. Bone disease in