Hepatic osteodystrophy refers to metabolic Bone abnormalities observed in chronic liver disease. It is an important complication of chronic liver disease which includes osteoporosis and the much rare osteomalacia. It is varying from 13% to 70%, depending on the population studied and the diagnostic criteria used to define bone disease.
The advances in bone densitometry and the development of newer techniques, such as dual energy x-ray absorptiometry (DEXA), make it possible to rapidly and precisely quantify the amount of bone in the relevant fracture sites. DEXA is noninvasive, rapid, accurate, and safe. So it is the gold standard with which all other technologies are compared.
So in this study, BMD was measured using DEXA technique at 2 sites; antro-posterior lumbar spines and femoral neck in 30 cirrhotic patients and 10 healthy volunteers as a control group.
In addition routine laboratory investigations; CBC, ESR, Liver function tests, renal function tests, serum Na, K, Ca and Phosphorus, urinary 24 h Ca and viral markers; HBVs Ag and HCV Ab was done and abdominal U/S.
We concluded that liver cirrhosis is a direct and independent risk factor for bone loss which is mainly in the form of osteoporosis rather than osteomalacia and the degree of bone loss is related to severity of the liver disease as it worsens as the liver function does. The trabecular bone is more clearly affected than cortical bone.
So BMD should be measured in cirrhotic patients and management should be started in osteopenic and osteoporotic patients and follow up should be done.