Low Bone Mineral Density as a Risk Factor for Liver Cirrhosis

Area of Science:

• Hepatology
• Endocrinology
• Bone Metabolism

Background:

• The liver-bone axis highlights the interplay between liver and bone metabolism.
• Osteoporosis is a known complication of cirrhosis, but the predictive role of bone mineral density (BMD) for cirrhosis development remains unclear.

Purpose of the Study:

• To investigate the association between BMD and the risk of incident cirrhosis.
• To determine if BMD can serve as an early predictor for cirrhosis development.

Main Methods:

• Dual-energy x-ray absorptiometry (DXA) measured BMD at multiple sites in 7752 participants.
• Electronic health records were used to track incident cirrhosis and mortality over a median of 18.43 years.
• Cox proportional hazard models estimated hazard ratios (HRs) and 95% confidence intervals (CIs).

Main Results:

• Higher BMD T-scores at the femoral neck, total hip, and trochanter were significantly associated with a reduced risk of cirrhosis.
• Femoral neck: HR 0.56 (95% CI, 0.39-0.82); Total hip: HR 0.60 (95% CI, 0.44-0.82); Trochanter: HR 0.63 (95% CI, 0.46-0.88).
• These associations remained consistent across sensitivity analyses, including those adjusting for cirrhosis risk factors and liver enzymes.

Conclusions:

• Low BMD may represent a novel risk factor for cirrhosis.
• BMD measurements could serve as an early predictive marker for cirrhosis development.
• The findings underscore the clinical relevance of assessing BMD in the context of liver health.