Zhang Wei, Gong Hui, Su Zengcun, Zhang Xuping, Cao Shujuan
Department of Ultrasound.
Department of Rehabilitation, Shandong Provincial Qianfoshan Hospital.
Medicine (Baltimore). 2019 Aug;98(31):e16628. doi: 10.1097/MD.0000000000016628.
To investigate the differences in bone mineral density between patients with liver cirrhosis and healthy control, and to analyze the risk factors of hepatic osteoporosis in patients with HBV related liver cirrhosis.A total of 189 patients with liver cirrhosis and 207 health controls were enrolled. The bone mineral density of lumbar spine and femoral neck was examined by dual energy X-ray absorptiometry. -2.0 <T value <-1.0 defined as osteopenia, T value ≤-2.0 defined as osteoporosis.Bone mineral density in the cirrhotic group was significantly lower than that in the control group (lumbar: 1.02 ± 0.16 vs 1.08 ± 0.13, P < .001; femoral neck: 0.86 ± 0.14 vs 0.91 ± 0.14, P < .001). Both 2 groups showed a tendency that decrease bone density correlated with age and decrease body mass index (BMI). Multivariate correlation analysis showed that women (OR = 6.931, P = .002), age (OR = 1.096, P < .001), low BMI (OR = 0.874, P = .037), and high liver stiffness value (OR = 1.125, P = .046) were independent risk factors for osteopenia and low body weight (OR = 0.934, P = .006) and high liver stiffness value (OR = 1.246, P = .034) were independent risk factors for osteoporosis.Our study shows that bone mineral density in patients with liver cirrhosis decreased significantly, especially in the elderly and low BMI patient. For HBV-related cirrhosis with risk factors, a regular bone density screening should be given, and timely intervention should be taken into consideration.
为研究肝硬化患者与健康对照者骨密度的差异,并分析乙型肝炎病毒(HBV)相关肝硬化患者肝性骨质疏松的危险因素。共纳入189例肝硬化患者和207例健康对照者。采用双能X线吸收法检测腰椎和股骨颈的骨密度。T值在-2.0至-1.0之间定义为骨量减少,T值≤-2.0定义为骨质疏松。肝硬化组的骨密度显著低于对照组(腰椎:1.02±0.16 vs 1.08±0.13,P<.001;股骨颈:0.86±0.14 vs 0.91±0.14,P<.001)。两组均呈现骨密度降低与年龄和体重指数(BMI)降低相关的趋势。多因素相关性分析显示,女性(OR=6.931,P=.002)、年龄(OR=1.096,P<.001)、低BMI(OR=0.874,P=.037)和高肝脏硬度值(OR=1.125,P=.046)是骨量减少的独立危险因素,低体重(OR=0.934,P=.006)和高肝脏硬度值(OR=1.246,P=.034)是骨质疏松的独立危险因素。我们的研究表明,肝硬化患者的骨密度显著降低,尤其是老年和低BMI患者。对于具有危险因素的HBV相关肝硬化患者,应定期进行骨密度筛查,并考虑及时干预。