Related Experiment Video
Updated: Mar 14, 2026
The Murine Choline-Deficient, Ethionine-Supplemented CDE Diet Model of Chronic Liver Injury
Published on: October 21, 2017
Study of Hepatic Osteodystrophy in Patients with Chronic Liver Disease
Yogesh Karoli1, Ritu Karoli2, Jalees Fatima3
1Senior Consultant Orthopaedic Surgeon, Department of Orthopaedics, Ram Manohar Lohia Combined Hospital , Gomti Nagar, Lucknow, Uttar Pradesh, India .
Insights
Hepatic osteodystrophy, a bone disease in chronic liver disease (CLD) patients, is highly prevalent. Early diagnosis and management of low bone mineral density (BMD) are crucial for improving patient survival and quality of life.
Area of Science:
- Hepatology
- Endocrinology
- Bone Metabolism
Background:
- Chronic Liver Disease (CLD) affects millions globally, presenting significant haemodynamic and metabolic challenges.
- Hepatic osteodystrophy, a metabolic bone disease, is an under-recognized complication in CLD patients, impacting morbidity, quality of life, and mortality due to fractures.
- Early identification of risk factors for bone mass loss in CLD is essential for timely intervention.
Purpose of the Study:
- To determine the prevalence of metabolic bone disease in patients with cirrhosis.
- To identify risk factors associated with hepatic osteodystrophy in individuals suffering from chronic liver disease.
Main Methods:
- An observational, cross-sectional study was conducted involving adult patients diagnosed with chronic liver disease or cirrhosis.
- Participants underwent comprehensive haematological, biochemical, and hormonal assessments, including Vitamin D levels.
- Bone Mineral Density (BMD) was evaluated using Dual Energy X-ray Absorptiometry (DEXA).
Main Results:
- The study included 72 patients with a mean age of 50.04 years.
- A high prevalence of low Bone Mineral Density (BMD) was observed, with 70.8% of patients exhibiting reduced BMD, including osteopenia and osteoporosis.
- Low Vitamin D levels and advanced liver disease severity were correlated with decreased BMD.
Conclusions:
- Low BMD is a common complication across various aetiologies of chronic liver disease.
- Further randomized, prospective studies on homogeneous CLD groups are recommended to better characterize hepatic osteodystrophy.
- Characterizing and managing bone disease in CLD patients is vital for enhancing survival and quality of life, given available therapeutic options.
Introduction:
Chronic Liver Disease (CLD) is a major cause of morbidity and mortality worldwide. It involves haemodynamic and metabolic complications. Hepatic Osteodystrophy is a metabolic bone disease that may occur in individuals with chronic liver disease. It can significantly affect morbidity and quality of life of these patients. Fractures are also associated with an excess mortality. It has been an under recognized and inadequately studied complication among Indian population. An early diagnosis is essential to correct reversible risk factors which predispose to bone mass loss.
Aim:
To assess the prevalence of metabolic bone disease and identify the risk factors associated with hepatic osteodystrophy in patients with cirrhosis.
Materials And Methods:
This was an observational, cross-sectional, hospital based study conducted at a medical college hospital. All patients more than 20-year-old, diagnosed with chronic liver disease/Cirrhosis were enrolled. They were subjected to haematological, biochemical investigations, evaluation of Vitamin D and other hormonal parameters. Bone Mineral Density (BMD) was estimated by Dual Energy X-ray Absorptiometry (DEXA).
Results:
A total of 72 patients with mean age 50.04±11.24 years were included in the study. Amongst causes of chronic liver disease were alcoholic liver disease 22 (30.6%), CLD due to hepatitis B 24 (33.3%) and chronic hepatitis C 26 (36.1%). Twenty one (29.2%) patients had normal BMD while 51 (70.8%) had a low BMD. Out of these 51 patients, 36 (70.6%) were diagnosed of osteopenia and 15 (29.4%) others were found to have osteoporosis. Vitamin D levels and severity of liver disease had correlation with low BMD.
Conclusion:
Low BMD is highly prevalent in patients with chronic liver disease of variable aetiologies. We advocate more randomised and prospective studies to be conducted on homogeneous groups with chronic liver disease in its various stages. In view of numerous therapeutic options available both for liver disease and bone disease, it is prudent to characterize this condition in order to give these patients a better chance of survival with good quality of life.
Related Concept Videos
01:26Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
01:08Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:24Chronic Kidney Disease II: Clinical Manifestations
01:14Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug