Underweight May Be a Risk Factor for Lower Bone Density in Chronic Hepatitis C Infected Male Patients
American Journal of Internal Medicine
Volume 3, Issue 5, September 2015, Pages: 213-216
Received: Aug. 22, 2015; Accepted: Aug. 29, 2015; Published: Sep. 9, 2015
Views 4090      Downloads 105
Amin R. Soliman, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Hatem Darwish, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Ahmed Hamdy, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Mahmoud A. Soliman, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Article Tools
Follow on us
Background/Aim of the study: Osteoporosis and osteopenia are well known complications in patients with chronic liver disease, we aimed to investigate Egyptian male patients with chronic hepatitis C infection as regard the bone mineral density and risk factors for osteoporosis in this subpopulation and correlating it to BMI (body mass index). Patients and methods: One Hundred ninety-three Egyptian male patients with hepatitis C virus CLD has been enrolled and consented: 116 under weight and 77 normal weight, Chronic HCV infection was confirmed by positive anti-HCV antibodies and HCV RNA PCR. Cirrhosis was diagnosed based on sonographic and laboratory criteria. Noninvasive methods were used: the FibroScan test was used for assessment of liver fibrosis. Blood was drawn for routine tests included total serum calcium, phosphate, creatinine and total alkaline phosphatase using standard methods. 25-hydroxy vitamin D (25OHD) were done. Bone mineral density: BMD of the lumbar spine, femoral neck: using dual energy x-ray absorptiometry (DEXA)Scan were analyzed by the same technician. Results were correlated to Body mass index and Serum vitamin D level. Results: Demographic Data and Clinical Characteristics of Under and Normal Weight Chronic Hepatitis C Men were recorded, the results showed statistically significant correlations between under and normal weight HCV patients regarding BMI and BMD (in right hip and femoral neck, p values were 0.002 and 0.004, respectively). Subnormal 25 hydroxy vitamin D levels were present in 64% of the underweight patients and 51% of the normal weight patients with no significant differences between both groups. Conclusion: the body weight and BMI might be more detrimental for low BMD in male patients with CLD secondary to HCV infection rather than vitamin D status.
Chronic Hepatitis C, Low Vitamin D Level, Underweight, Bone Mineral Density
To cite this article
Amin R. Soliman, Hatem Darwish, Ahmed Hamdy, Mahmoud A. Soliman, Underweight May Be a Risk Factor for Lower Bone Density in Chronic Hepatitis C Infected Male Patients, American Journal of Internal Medicine. Vol. 3, No. 5, 2015, pp. 213-216. doi: 10.11648/j.ajim.20150305.14
Habib M, Mohamed M, Abdel-Aziz F, Magder L, Abdel-Hamid M, Gamil F, et al. Hepatitis C virus infection in a community in the Nile Delta: risk factors for seropositivity. Hepatology 2001; 33(1): 248.
WHO Global surveillance and control of hepatitis C. Report of a WHO Consultation organized in collaboration with the Viral Hepatitis Prevention Board, Antwerp, Belgium. J Viral Hepat 1999; 6:35–47
Lin J, Hsieh T, Wu C, Chen P, Chueh T, Chang W, et al. Association between chronic hepatitis C virus infection and bone mineral density. Calcif Tissue Int. Dec 2012; 91(6):423-429.
Hay JE, Guichelaar MM. Evaluation and management of osteoporosis in liver disease. Clin Liver Dis 2005; 9: 747–66.
Rachner T, Khosla S, Hofbauer L. Osteoporosis: now and the future. The Lancet. 2001; 377(9773): 1276–1287.
Yousfi MM, Balan V, Douglas DD, Harrison ME, Mulligan DC, Moss AA, et al. End-stage liver disease secondary to hepatitis C infection and alcohol is a risk factor for osteoporosis [abstract]. Hepatology 2001;34:A232.
McCullough AJ, O’Connor JF. Alcoholic liver disease: Proposed recommendations for the American College of Gastroenterology. Am J Gastroenterol 1998;93:2022-2036.
Hay JE, Guichelaar MM Evaluation and management of osteoporosis in liver disease. Clin Liver Dis 2005; 9:747–766.
Leslie WD, Bernstein CN, Leboff MS AGA technical review on osteoporosis in hepatic disorders. Gastroenterology 2003; 125:941–966.
Luxon BA. Bone disorders in chronic liver diseases Curr Gastroen¬terol Rep 2011, 13 (1):40-8. Guanabens N, Pares A. Liver and bone Arch Biochem Biophys 2010, 503(1): 84-94.
Frost HM. The pathomechanics of osteoporoses. Clin Orthop 1995; 200:198-225.
Slemenda CW, Hui SL, Longcope C, Wellman H, Johnston CC. Predictors of bone mass in penmenopausal women. Ann Intern Med l990;l 12:96-101
Ribot C, Tremollieres F, Pouilles JM, Bonneu M, Germain F, Louvet JP. Obesity and postmenopausal bone loss: the influence of obesity on vertebral density and bone turnover in postmenopausal women. Bone 1988;8:327-31.
Shiraki M, Ito H, Fujimaki H, Higuchi T. Relation between body size and bone mineral density with special reference to sex hormones and calcium regulating hormones in elderly females. Endocrinol 1pm 1991;38:343-9.
Greenspan SL, Myers ER, Maitland LA, Resnick NM, Hayes WC. Fall severity and bone mineral density as risk factors for hip fracture in ambulatory elderly. JAMA l994; 271:l28-33.
Holbrook U, Barrett-Connor E. The association of lifetime weight and weight control patterns with bone mineral density in an adult community. Bone Miner 1993; 20:141-9.
Rico H, Revilla M, Villa LF, Hernandez ER, Fernandez JP. Crush fracture syndrome in senile osteoporosis: a nutritional consequence? J Bone Miner Res l992;7:317-9.
Woodson G. Dual X-ray absorptiometry T-score concordance and discordance between the hip and spine measurement sites. J Clin Densitom 2000;3:319-24.
Arteh J, Narra S, Nair S. Prevalence of vitamin D deficiency in chronic liver disease. Dig Dis Sci 2010; 55: 2624–8.
Teneva BH. Pathogenesis and assessment of renal function in patients with liver cirrhosis. Folia Med (Plovdiv) 2012;54 (4):5-13.
Chen CC, Wang SS, Jeng FS, Lee SD. Metabolic bone disease of liver cirrhosis: Is it parallel to the clinical severity of cirrhosis? J Gastroenterol Hepatol 1996; 11: 417–21.
Crawford BAL, Kam C, Donaghy AJ, Mccaughan GW. The heterogeneity of bone disease in cirrhosis: A multivariate analysis. Osteoporos Int 2003; 14: 987–94.
Menon KV, Angulo P, Weston S, Dickson ER, Lindor KD. Bone disease in primary biliary cirrhosis: independent indicators and rate of progression. J Hepatol 2001; 35: 316–23.
Petta S, Camma C, Scazzone C, et al. Low vitamin D serum level is related to severe fibrosis and low responsiveness to interferon-based therapy in genotype 1 chronic hepatitis C. Hepatology 2010; 51: 1158–67.
Bitetto D, Fattovich G, Fabris C, et al. Complementary role of vitamin D deficiency and the interleukin-28B rs12979860 C/T polymorphism in predicting antiviral response in chronic hepatitis C. Hepatology 2011; 53: 1118–26.
Bitetto D, Fabris C, Fornasiere E, et al. Vitamin D supplementation improves response to antiviral treatment for recurrent hepatitis C. Transpl Int 2011; 24: 43–50.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186