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Proximal Hip Geometry, Trabecular Bone Score, Bone Mineral Density and Bone Mineral Parameters in Patients With
Preyander Thakur1, Kripa Elizabeth Cherian2, Nitin Kapoor2
1Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India; Department of Endocrinology & Metabolism, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India.
Insights
Bone health is significantly impacted in Indian men with early cryptogenic cirrhosis. This condition leads to lower bone mineral density and poorer bone geometry, increasing fracture risk.
Area of Science:
- Hepatology and Endocrinology
- Bone Metabolism Research
Background:
- Cryptogenic cirrhosis, a leading cause of liver disease in India, has unknown effects on bone health.
- Early assessment of skeletal integrity is crucial for managing patients with chronic liver disease.
Purpose of the Study:
- To investigate and compare bone health parameters in Indian male patients with early cryptogenic cirrhosis (Child-Turcot-Pugh A) against those with Hepatitis B-related chronic liver disease and healthy controls.
- To evaluate bone mineral density (BMD), trabecular bone score (TBS), and hip structural analysis (HSA) in these groups.
Main Methods:
- A cross-sectional study involving 30 male subjects per group: early cryptogenic cirrhosis, Hepatitis B-related chronic liver disease, and healthy controls.
- Assessment included BMD, TBS, HSA, and bone mineral parameters, with statistical analysis to compare groups.
Main Results:
- Patients with cryptogenic cirrhosis showed significantly lower mean 25-hydroxy vitamin D levels compared to controls.
- Significantly lower TBS was observed in cryptogenic cirrhosis patients versus Hepatitis B-CLD and healthy controls.
- BMD at the hip and lumbar spine, along with most HSA components, were significantly reduced in cryptogenic cirrhosis patients.
Conclusions:
- Early cryptogenic cirrhosis in Indian men is associated with compromised bone health, evidenced by low TBS, BMD, and altered hip geometry.
- These skeletal deficits in cryptogenic cirrhosis patients may indicate a higher risk for future fragility fractures.
Abstract:
The impact of cryptogenic cirrhosis on skeleton has not been studied in Indian context. So this study investigated bone health in male patients with early cryptogenic cirrhosis as defined by Child-Turcot-Pugh A (CTP-A) categorization and compared it with patients diagnosed to have hepatitis B related chronic liver disease (CLD) on treatment and age, sex-matched healthy controls. It was a cross-sectional study, in which thirty male subjects were recruited in each group. Bone mineral density (BMD), trabecular bone score (TBS), hip structural analysis (HSA) and bone mineral parameters were assessed. The mean ±SD age of the study subjects was 39.3 ± 9.2 years. The mean 25-hydroxy vitamin D was significantly lower in subjects with cryptogenic cirrhosis as compared to controls (p = 0.001). Subjects with cryptogenic cirrhosis had significantly lower (1.297 ± 0.099) TBS as compared to hepatitis-B related CLD (1.350 ± 0.094) control subjects (1.351 ± 0.088) (p = 0.04). BMD at the hip and lumbar spine was also significantly lower in subjects with cryptogenic cirrhosis as compared to hepatitis-B related CLD and healthy age matched controls (p < 0.05). Most components of HSA were significantly affected in subjects with cryptogenic cirrhosis as compared to control subjects (p < 0.05). Patients with cryptogenic cirrhosis had significantly low TBS and BMD lumbar spine and hip as well as poor proximal hip geometry which may be good predictor of future fragility fractures.
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