Evaluation of Bone Metabolism in Patients with Chronic Liver Disease due to Chronic Hepatitis B or C Infection

zObjective: Osteoporosis in chronic liver disease is couldn't be determined exactly.We aimed to investigate how the severity of liver function disorders affects bone mineral density (BMD) and the hormonal parameters associated with BMD in chronic hepatitis and cirrhosis patients.Methods: A total of 32 patients (16 females) with chronic hepatitis associated with hepatitis B virus and hepatitis C virus and 32 patients (14 females) with liver cirrhosis were enrolled.Vitamin 25-hydroxy-D 3, calcium, parathyroid hormone (PTH), testosterone, estradiol, and dehydroepiandrosterone sulfate (DHEAS) levels evaluated.All patients underwent lumbar and femur neck BMD assessments. Results:In patients with cirrhosis, the osteoporosis rate was 40.6 and the osteopenia rate was 28.1; in patients with hepatitis, the osteopenia rate was 43.8% and there were no osteoporotic patients.In the cirrhosis group, vitamin D levels were significantly lower than those in the hepatitis group (p<0.05).Calcium, PTH, testosterone, and estradiol levels were similar between the groups.DHEAS levels were lower in the cirrhosis group.In subgroup analyses; estradiol levels in cirrhotic women were lower than women with hepatitis.A positive correlation was observed between albumin levels and the femur T-score (p=0.002).There was no significant relationship between BMD and etiologic agent use, hepatic activity index, fibrosis and Child-Pugh score. Conclusion:In cirrhotic patients, osteoporosis rates were significantly higher.The absence of a complete correlation between liver fibrosis and child stage and BMD signs that different factors play roles in osteoporosis development.In patients with cirrhosis, low vitamin D and DHEAS levels and in female patients with cirrhosis, impairment of estradiol were found to be important factors in osteoporosis.