Longitudinal changes of bone mineral content with age in patients with cirrhosis of the liver

Bone disorders are associated with cirrhosis. Knowledge of the natural course of bone changes in cirrhosis could help in decision-making about medical treatment. We carried out one measurement of bone mineral density (BMD) in 184 Japanese patients (98 men and 86 women) with cirrhosis by dual-energy X-ray absorptiometry. Differences in BMD values means +/- SD between the 98 cirrhotic men and 283 healthy men of the same age reported in another study were not significant. In the 86 cirrhotic women, BMD tended to show a greater decrease with age than in healthy controls reported elsewhere. Differences in BMD values (means +/- SD) between 622 healthy women reported elsewhere and our patients were not significant for women up to age 60 years, but at 60 years or more, the mean BMD in cirrhotic women (0.692 +/- 0.100) was lower than that in healthy women (0.749 +/- 0.101; P < 0.01). In 61 of the 184 patients (31 men and 30 women), the bone mineral content (BMC) of lumbar vertebrae was measured at least twice, at intervals of 10-72 months. In this longitudinal part of the study, the group mean of estimated annual change for cirrhotic men was -0.4%, close to that of healthy men (-0.2%). This mean in cirrhotic women was -2.8%, significantly different from that of healthy women (-1.1%; P < 0.05). As expected, cirrhotic women were the most likely to lose BMC, and many needed prompt treatment.