Baccaro L F, Boin I F S F, Pedro A O, Costa-Paiva L, Leal A L G, Ramos C D, Pinto-Neto A M
Department of Gynecology, State University of Campinas, Campinas, Brazil.
Transplant Proc. 2011 May;43(4):1351-6. doi: 10.1016/j.transproceed.2011.02.027.
In the future, an increasing number of female liver transplant recipients will reach the climacteric with osteoporosis as a common complication. We evaluated the factors associated with decreased bone mass among women after liver transplantation.
A prospective, cross-sectional study of 23 outpatient transplant recipients followed from February 2009 to March 2010 included women of age ≥35 years after liver transplantations ≥1 year prior. We recorded patient histories, liver enzyme levels, as well as bone mineral densities measured at the lumbar spine and femur. Statistical analysis used Fisher's exact test, simple odds ratio (OR), and Spearman's rank correlation coefficient.
The mean patient age was 52.5 ± 11 years with 30.4% premenopausal, and 69.6% perimenopausal or postmenopausal. Approximately 21% showed osteoporosis and 35%, a low bone mass. Postmenopausal women: OR 69.0 (95% CI 2.89-1647.18; P<.0001), aged ≥49 years: OR 13.33 (95% CI 1.78-100.15; P=.0123) and receiving a transplant after 44 years of age: OR 49.50 (95% CI 3.84-638.43; P<.0001) were associated with a lower bone mass. Having undergone transplantation for more than 5.8 years lowered the risk of bone mass change: OR 0.11 (95% CI 0.02-0.78; P=.0361). Clinical and laboratory variables, including corticosteroid use, were not associated with decreased bone mass.
Understanding the prevalence and factors associated with osteoporosis among female liver transplant recipients is important to enhance the strategies to diagnose and treat these women, seeking to improve their quality of life.
未来，越来越多接受肝移植的女性将步入更年期，骨质疏松是常见并发症。我们评估了肝移植术后女性骨量减少的相关因素。
一项前瞻性横断面研究，对2009年2月至2010年3月随访的23例门诊移植受者进行研究，纳入肝移植术后≥1年、年龄≥35岁的女性。我们记录了患者病史、肝酶水平以及腰椎和股骨的骨密度。统计分析采用Fisher精确检验、简单比值比（OR）和Spearman等级相关系数。
患者平均年龄为52.5±11岁，其中30.4%为绝经前女性，69.6%为围绝经期或绝经后女性。约21%表现为骨质疏松，35%骨量低。绝经后女性：OR为69.0（95%CI 2.89 - 1647.18；P<0.0001），年龄≥49岁：OR为13.33（95%CI 1.78 - 100.15；P = 0.0123），44岁后接受移植：OR为49.50（95%CI 3.84 - 638.43；P<0.0001）与较低骨量相关。移植超过5.8年可降低骨量变化风险：OR为0.11（95%CI 0.02 - 0.78；P = 0.0361）。包括使用皮质类固醇在内的临床和实验室变量与骨量减少无关。
了解女性肝移植受者骨质疏松的患病率及相关因素，对于加强这些女性的诊断和治疗策略、改善其生活质量至关重要。
