Frequency of Low Bone Mineral Density (BMD) in Patients with Liver Cirrhosis
Ihsanullah Rajar *
Department of Medicine, LUMHS, Pakistan.
Nasrullah Aamer
Peoples University of Medical & Health Sciences Nawabshah, Pakistan.
Narindar Kumar
Department of Medicine, Bhitai Dental and Medical College, Mirpurkhas, Pakistan.
Prem Kumar
Department of Gastroenterology, Isra University Hospital Hyderabad, Pakistan.
Kapeel Raja
Department of Gastroenterology, Hepatology & Nutrition, PAQSJIMS, Pakistan.
Muhammad Akram Bajwa
Department of Gastroenterology, LUMHS, Pakistan.
*Author to whom correspondence should be addressed.
Abstract
Objective: The objective of this study was to evaluate the low bone mineral density (BMD) in patients with liver cirrhosis.
Methodology: This cross sectional study on 151 Liver cirrhotic patients was conducted at Liaquat
University Hospital Hyderabad/Jamshoro. This study duration was 6 months, July 2015 to December 2015. The Assessment of bone mineral density (BMD) for each relevant patient was done using ultrasound impedance Dual Energy X-ray Absorptiometry (DEXA) by senior pathologist having ≥05 years of experience, across the calcaneum, at lumbar spine (LS) and femur neck (FN), were computed by using computer supported device. The BMD was expressed in terms of T score. The WHO standard value was utilized to define the low BMD / osteoporosis is T score -1.5.
Results: The mean age of subjects was 31.32±6.18 years. Out of all, 62.9% were males whereas 37.1% were females. About 21% patients had low/abnormal bone mineral density (BMD). Among these, 17.9% had bone mineral density (BMD) of -1.5 to -2.5 and 4% had BMD of <-2.5. Rest of 78.1% patients had a normal (>-1.5) bone mineral density (BMD). Majority of patients, 63.6% had a CTP grade B of liver cirrhosis, whereas 22.5% had A grade and 13.9% had C grade of liver cirrhosis.
Conclusion: Conclusively, the risk of low bone mineral density (BMD) was evidently high for patients with hepatic cirrhosis. Male gender and age above 30 years were found at greater risk and CTP grade B of cirrhosis was most common.
Keywords: Liver cirrhosis, bone mineral density, metabolic disease.