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Pharma Summit 2018 & Gastro Summit 2018 Asian Journal of Biomedical and Pharmaceutical Sciences | ISSN: 2249-622X | Volume 8
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GASTROENTEROLOGY AND HEPATOLOGY
2
nd
International Conference on
Mukesh Prasad Sah, Asian J Biomed Pharmaceut Sci 2018, Volume 8 | DOI: 10.4066/2249-622X-C5-014
PREVALENCE OF OSTEOPENIA,
OSTEOPOROSIS AND HYPOVITAMINOSIS
D IN PATIENT OF CIRRHOSIS OF LIVER AND
THEIR CORRELATION WITH SEVERITY
Mukesh Prasad Sah
KIST Medical College and Teaching Hospital, Nepal
Background:
Hepatic osteodystrophy is a frequent late complication in chron-
ic liver diseases in which patients usually present with bone mineral density
reduction, osteopenia, and osteoporosis and fractures. Hepatic osteodys-
trophy is an important extrahepatic manifestation of advanced liver disease
mimicking features of classical osteoporosis with an increased risk for frac-
tures. Cirrhotic patients present with lower levels of 25-hydroxyvitamin D and
1, 25 dihydroxy vitamin D. They also have diminished bone mineral density,
most frequently in the spine.
Objective:
The present study was conducted with an objective to assess os-
teopenia & osteoporosis and measure the concentrations of 25-hydroxy vi-
tamin D in patients with cirrhosis of liver and their correlation with severity.
Materials and Methods:
This cross-sectional analytical study was conduct-
ed in the Department of Gastroenterology, BSMMU, Bangladesh during the
period of January 2016 to September 20017. 70 eligible patients more than
18-year-old, diagnosed with chronic liver disease/Cirrhosis were enrolled.
They were subjected to haematological, biochemical investigations, evalua-
tion of Vitamin D. Bone Mineral Density (BMD) was estimated by Dual Energy
X-ray Absorptiometry (DEXA). Patient’s samples were collected, tested and
results recorded.
Results:
A total of 70 patients with mean age 51.5±10.1 years (M-51.4%) were
included in the study. Among them 7(10%) patients had normal BMD while 63
(90%) had a low BMD. Out of these 63 patients, 10 (14.3%) were diagnosed to
have osteopenia and 53(75.7%) were found to have osteoporosis. The prev-
alence of low BMD in patients of cirrhosis of liver were 90% among them
14.3% were osteopenia and 75.7% were osteoporosis whereas prevalence of
Serum 25 (OH) D were 92.9%. In bone marrow density based on CTP scor-
ing we found that in CTP-A, higher number of patients were in osteoporosis
(37.71%) followed by osteopenia and normal. In the CTP-A, B and C higher
number of patients were in osteoporosis group. The difference in prevalence
of osteopenia and osteoporosis among various Child groups was not signifi-
Mukesh Prasad Sah is an assistant professor at KIST
Medical college and teaching Hospital, Nepal. He is the
member of the Nepalese Association of Surgical Gastro-
enterology (NASG) and Nepalese society of Gastroenter-
ologist. He was medical officer and tutor at JMC Teach-
ing Hospital, Nepal (2009-2011), and has completed his
sMD residency (2018) in gastroenterology from Dhaka,
Bangladesh. His areas of interest and research works are
in metabolic liver disease and Gut microbiota.
mukeshjnk@gmail.comBIOGRAPHY
cant statistically. Mean S. vitamin 25(OH)D were
24.9±6.3, 13.6±5.2 and 10.4±4.4 in Child-Pugh
A, Child-Pugh B and Child-Pugh C stages respec-
tively. Mean S. vitamin 25(OH)D was gradually
decreased as the changes of stage from lower
to higher. Vitamin D levels and severity of liver
disease had linear correlation with low BMD.
Conclusion:
Among the liver diseases patients
90% of themwere with Low BMD. The prevalence
of low BMD in patients of cirrhosis of liver were
90% among them 14.3% were osteopenia and
75.7% were osteoporosis whereas prevalence
of Serum 25 (OH) D were 92.9%. There were no
correlations with gender, severity of liver disease
by CTP score and etiology of liver cirrhosis did
not determine hepatic osteodystrophy. There
was linear decreased in mean s. vitamin 25(OH)
D as the changes of stage from lower to higher.
Routine vitamin D testing and early scanning for
osteoporosis in patients with liver cirrhosis will
reduce the risk of morbidity and mortality.