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Open Access 01-06-2019 | Original Article

Bone microarchitecture and bone turnover in hepatic cirrhosis

Authors: R. Wakolbinger, C. Muschitz, G. Scheriau, G. Bodlaj, R. Kocijan, X. Feichtinger, J. E. Schanda, J. Haschka, H. Resch, P. Pietschmann

Published in: Osteoporosis International | Issue 6/2019

Abstract

Summary

Liver cirrhosis leads to bone loss. To date, information on bone quality (three-dimensional microarchitecture) and, thus, bone strength is scarce. We observed decreased bone quality at both assessed sites, independent of disease severity. Therefore, all patients should undergo early-stage screening for osteoporosis.

Introduction

Recent studies found low bone mineral density in cirrhosis, but data on bone microstructure are scarce. This study assessed weight-bearing and non-weight-bearing bones in patients with cirrhosis and healthy controls. The primary objective was to evaluate trabecular and cortical microarchitecture.

Methods

This was a single-center study in patients with recently diagnosed hepatic cirrhosis. Thirty-two patients and 32 controls participated in this study. After determining the type of cirrhosis, the parameters of bone microarchitecture were assessed by high-resolution peripheral quantitative computed tomography.

Results

Both cortical and trabecular microarchitectures showed significant alterations. At the radius, trabecular bone volume fraction was 17% lower (corrected p = 0.028), and, at the tibia, differences were slightly more pronounced. Trabecular bone volume fraction was 19% lower (p = 0.024), cortical bone mineral density 7% (p = 0.007), and cortical thickness 28% (p = 0.001), while cortical porosity was 32% higher (p = 0.023), compared to controls. Areal bone mineral density was lower (lumbar spine − 13%, total hip − 11%, total body − 9%, radius − 17%, and calcaneus − 26%). There was no correlation between disease severity and microarchitecture. Areal bone mineral density (aBMD) measured by dual-energy X-ray absorptiometry (DXA) correlated well with parameters of cortical and trabecular microarchitecture.

Conclusions

Hepatic 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.

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Title: Bone microarchitecture and bone turnover in hepatic cirrhosis
Authors: R. Wakolbinger
C. Muschitz
G. Scheriau
G. Bodlaj
R. Kocijan
X. Feichtinger
J. E. Schanda
J. Haschka
H. Resch
P. Pietschmann
Publication date: 01-06-2019
Publisher: Springer London
Published in: Osteoporosis International / Issue 6/2019
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-019-04870-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Bone microarchitecture and bone turnover in hepatic cirrhosis

Abstract

Summary

Introduction

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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