Association between osteoporosis and hepatitis B cirrhosis: a case-control study

Afr Health Sci. 2020 Dec;20(4):1610-1616. doi: 10.4314/ahs.v20i4.13.

Abstract

Background and aims: Hepatitis B virus (HBV)-related cirrhosis is associated with decreased bone mineral density (BMD); however, the mechanism is yet unknown. To assess the incidence of osteoporosis in patients with HBV-associated cirrhosis and relevant mechanisms.

Methods: A total of 80 hospitalized patients with HBV-associated cirrhosis and 80 healthy controls were enrolled. The levels of serum osteocalcin, total procollagen type 1 amino-terminal propeptide, β-C-terminal telopeptide of type I collagen (β-CTX), and 25-hydroxy vitamin D3 (25(OH)D3) was evaluated in the cirrhosis group.

Results: The BMDs of the lumbar spine (P<0.001) and hip joints (P=0.015) in the cirrhosis group were significantly lower than those in the controls. The incidence of osteoporosis in the cirrhosis group was significantly higher than that in the control group (P<0.001). Compared to the patients of the Child-Pugh grade A and B, the BMD of lumbar spine and 25(OH)D3 was significantly decreased in patients of grade C, while β-CTX was elevated. Patients in the cirrhosis group faced a higher risk of osteoporosis as compared to the controls(P<0.001).

Conclusions: Enhanced bone resorption accounted for increased risk of osteoporosis in severe cirrhosis. Thus, HBV-associated cirrhosis was a risk factor for osteoporosis.

Keywords: Liver cirrhosis; bone density; chronic; hepatitis B; osteopenia; osteoporosis.

MeSH terms

  • Adult
  • Aged
  • Bone Density
  • Bone Diseases, Metabolic / epidemiology*
  • Case-Control Studies
  • China / epidemiology
  • Collagen Type I / blood
  • Hepatitis B, Chronic / epidemiology*
  • Humans
  • Incidence
  • Liver Cirrhosis / epidemiology*
  • Male
  • Middle Aged
  • Osteocalcin / blood
  • Osteoporosis / epidemiology*
  • Parathyroid Hormone / blood
  • Peptides / blood
  • Vitamin D / blood

Substances

  • Collagen Type I
  • Parathyroid Hormone
  • Peptides
  • Osteocalcin
  • Vitamin D