Department of Food and Nutrition, Faculty of Pharmaceutical Sciences, State University of São Paulo - UNESP, Endereço: Avenida Bandeirantes, 3900. Monte Alegre, Ribeirão Preto, São Paulo, 14049-900, Brazil.
Department of Clinical Medicine, Ribeirão Preto Medical School, University of São Paulo - FMRP/USP, São Paulo, Brazil.
Sci Rep. 2021 May 13;11(1):10162. doi: 10.1038/s41598-021-89486-9.
Nucleoside/nucleotide analogs such as tenofovir, have been used as long-term therapy for the treatment of hepatitis B and side effects such as the reduction in bone mineral density have been associated with their use. To determine the relationships between bone, hormonal, biochemical, and mineral parameters in patients with hepatitis B treated with nucleoside/nucleotide antiviral. A cross-sectional study was conducted with 81 adult patients with chronic hepatitis B infection. Dual-energy X-ray absorptiometry (DXA) was performed to assess bone mineral density. Biochemical analyses were performed for osteocalcin, deoxypyridinoline, parathyroid hormone, vitamin D, IGF-1, TSH, testosterone, estradiol, FSH, transaminases, urea, creatinine, calcium, serum and urinary phosphorus, magnesium, and FGF-23, body composition was performed by DXA. Participants, both gender, were divided according to the use of antiretrovirals: Group1: 27 inactive virus carriers without medication; Group2: 27 patients using tenofovir; and Group3: 27 patients using lamivudine or entecavir. DXA readings diagnosed osteopenia in the lumbar spine for 7.4% of individuals in Group1, 15% in Group2, and 3.7% in Group3. For all groups, we observed normal values in bone formation markers, osteocalcin levels as well as parathyroid hormone, insulin growth factor 1, and FGF-23. In all groups, we found increased levels of urinary deoxypyridinoline, a bone resorption marker. Increased levels in the bone resorption markers indicated a high resorptive activity of bone tissue. These data suggested high resorption activity of bone tissue in hepatitis B virus-infected patients independent of the use of antiretrovirals.
核苷（酸）类似物如替诺福韦已被用作乙型肝炎的长期治疗药物，其使用与骨密度降低等副作用有关。为了确定接受核苷（酸）抗病毒治疗的乙型肝炎患者的骨、激素、生化和矿物质参数之间的关系。对 81 例慢性乙型肝炎感染成年患者进行了横断面研究。使用双能 X 线吸收法（DXA）评估骨矿物质密度。进行生化分析以评估骨钙素、脱氧吡啶啉、甲状旁腺激素、维生素 D、IGF-1、TSH、睾酮、雌二醇、FSH、转氨酶、尿素、肌酐、钙、血清和尿磷、镁和 FGF-23，通过 DXA 进行身体成分分析。根据使用抗病毒药物的情况，将参与者分为男女两组：组 1：27 例无药物治疗的病毒不活跃携带者；组 2：27 例使用替诺福韦的患者；组 3：27 例使用拉米夫定或恩替卡韦的患者。DXA 读数诊断组 1 中 7.4%的个体腰椎骨密度降低，组 2 中 15%的个体腰椎骨密度降低，组 3 中 3.7%的个体腰椎骨密度降低。对于所有组，我们观察到骨形成标志物骨钙素水平以及甲状旁腺激素、胰岛素生长因子 1 和 FGF-23 的正常水平。在所有组中，我们都发现尿脱氧吡啶啉（一种骨吸收标志物）水平升高。骨吸收标志物水平升高表明骨组织的高吸收活性。这些数据表明，乙型肝炎病毒感染患者的骨组织具有高吸收活性，与使用抗病毒药物无关。
