| Bone mineral density and disorders of mineral metabolism in chronic liver disease. | |
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MedLine Citation:
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PMID: 19630107 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To estimate the prevalence and identify the risk factors for metabolic bone disease in patients with cirrhosis. METHODS: The study was performed on 72 Indian patients with cirrhosis (63 male, nine female; aged < 50 years). Etiology of cirrhosis was alcoholism (n = 37), hepatitis B (n = 25) and hepatitis C (n = 10). Twenty-three patients belonged to Child class A, while 39 were in class B and 10 in class C. Secondary causes for metabolic bone disease and osteoporosis were ruled out. Sunlight exposure, physical activity and dietary constituents were calculated. Complete metabolic profiles were derived, and bone mineral density (BMD) was measured using dual energy X ray absorptiometry. Low BMD was defined as a Z score below -2. RESULTS: Low BMD was found in 68% of patients. Lumbar spine was the most frequently and severely affected site. Risk factors for low BMD included low physical activity, decreased sunlight exposure, and low lean body mass. Calcium intake was adequate, with unfavorable calcium: protein ratio and calcium: phosphorus ratio. Vitamin D deficiency was highly prevalent (92%). There was a high incidence of hypogonadism (41%). Serum estradiol level was elevated significantly in patients with normal BMD. Insulin-like growth factor (IGF) 1 and IGF binding protein 3 levels were below the age-related normal range in both groups. IGF-1 was significantly lower in patients with low BMD. Serum osteocalcin level was low (68%) and urinary deoxypyridinoline to creatinine ratio was high (79%), which demonstrated low bone formation with high resorption. CONCLUSION: Patients with cirrhosis have low BMD. Contributory factors are reduced physical activity, low lean body mass, vitamin D deficiency and hypogonadism and low IGF-1 level. |
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Authors:
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Joe George; Hosahithlu K Ganesh; Shrikrishna Acharya; Tushar R Bandgar; Vyankatesh Shivane; Anjana Karvat; Shobna J Bhatia; Samir Shah; Padmavathy S Menon; Nalini Shah |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: World journal of gastroenterology : WJG Volume: 15 ISSN: 1007-9327 ISO Abbreviation: World J. Gastroenterol. Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-07-24 Completed Date: 2009-09-28 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 100883448 Medline TA: World J Gastroenterol Country: China |
Other Details:
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Languages: eng Pagination: 3516-22 Citation Subset: IM |
Affiliation:
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Department of Endocrinology, KEM Hospital, Parel, Mumbai 400012, India. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Bone Density* Bone Diseases, Metabolic* / epidemiology, etiology, physiopathology Chronic Disease Diet Estrogens / metabolism Female Humans Insulin-Like Growth Factor Binding Proteins / metabolism Insulin-Like Growth Factor I / metabolism Liver Diseases* / complications, physiopathology Male Middle Aged Motor Activity Sunlight Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Estrogens; 0/IGFBP3 protein, human; 0/Insulin-Like Growth Factor Binding Proteins; 67763-96-6/Insulin-Like Growth Factor I |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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