Abstract

JEANNERET, Valerie; ABRIL, Daniela Sofía  and  GONZALEZ, Deyanira. Bone loss in hepatic cirrhosis: phisiopathology of hepatic osteodystrophy. rev. colomb. cir. [online]. 2013, vol.28, n.3, pp.238-247. ISSN 2011-7582.

Cirrhosis is an advanced stage of fibrosis; it is a consequence of the progression of chronic liver disease, characterized by destruction of architecture and predisposes to the development of hepatocellular carcinoma. Cirrhosis cause complex metabolic changes that led to the development of alterations in bone metabolism known as hepatic osteodystrophy (HO). In general deterioration of bone mass and quality are due to multiple factors such as nutritional deficiencies, hypogonadism, use of medications, vitamin D deficiency, chronic inflammation and severity of the disease. The incidence of osteoporosis is twice as high in patients with chronic liver disease compared with the general population. The rates of vertebral and nonvertebral fractures are increased in chronic liver disease, especially in postmenopausal women. The availability of DXA bone densitometry (BMD-DXA) has led to an increase in the diagnosis of osteoporosis and low bone mass (LBM)in patients with liver disease. Moreover, vertebral morphometry (VMP) has a high diagnostic yield of asymptomatic vertebral fractures. This an update of the literature on bone disease in patient with chronic liver disease and recommendations for the management of patients with cirrhosis, focusing on bone health.

Keywords : liver cirrhosis; liver transplantation; osteodystrophy; osteoporosis; fracture.

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