[Bone metabolism in non-cholestatic chronic hepatopathy]

Osteoporosis may be associated with parenchymal hepatopathy and chronic alcoholism. Biochemical studies which are linked with bone metabolism and the bone densitometry may help to understand its physiopathology, before the symptoms appear and its consequences become inevitable.

The study of bone metabolism and densitometry has been carried out in a population of 86 males, distributed in 4 groups: group I, control (17 men), group II, patients with chronic hepatopathy without alcoholism (25 patients), group III, chronic alcoholic without hepatopathy (21 patients), and group IV, patients with chronic alcoholic hepatopathy (23 patients). The results of densitometry and biochemical parameters in relation with bone metabolism are cross checked among these 4 groups.

We found out that patients with chronic alcoholic hepatopathy have bone mineral density (BMD), at femoral level, significatively lower than that of the other 3 groups (p < 0.05). In chronic hepatopathy, regardless of its etiology, significant alterations in biochemical parameters of bone metabolism found, consisting basically in shrinked plasmatic level of 25-hydroxivitamin-D (25-OH-D) (p < 0.05). The plasmatic levels of calcitriol, magnesium and intact parathyroid hormone (PTHi) were significantly lower in chronic alcoholic hepatopathy than in the others 3 groups (p < 0.001, p < 0.001 and p < 0.05, respectively).

Chronic hepatopathy is associated with deficiency in vitamin D. Alcoholism added to chronic hepatopathy has a negative influence on the plasmatic levels of calcitriol, magnesium and PTHi as well as in the femur BMD. Alcoholism not associated with chronic hepatopathy is not sufficient to cause significant alterations in the studied parameters.