High Prevalence of Hormonal Changes and Hepatic Osteodystrophy in Frail Patients with Cirrhosis-An Observational Study

Overview

Journal J Clin Exp Hepatol

Publisher Elsevier

Specialty Gastroenterology

Date 2022 Jun 9

PMID 35677501

Authors

Surender Singh

Sunil Taneja

Puneeta Tandon

Arka De

Nipun Verma

Madhumita Premkumar

Ajay Duseja

Radha Krishan Dhiman

Virendra Singh

Affiliations

Soon will be listed here.

Abstract

Background/aim: Hormonal changes and hepatic osteodystrophy are less often studied complications of cirrhosis. This study describes the variance in hormones and osteodystrophy between Frail and Not frail patients with cirrhosis.

Methods: 116 outpatients with cirrhosis were prospectively enrolled in this study. Frailty assessment was done using Liver Frailty Index (LFI). Sociodemographic assessment, anthropometry, nutritional assessment, hormone profile, and dual-energy X-ray absorptiometry scan were done in all patients.

Results: 116 patients, predominantly males (100 (86.2%) with mean age of 50.16 years (95% CI, 48.43-51.89) were included. Malnutrition was more common in Frail group as compared to Not frail group. Subjective global assessment (SGA) class-B patients were significantly more in Frail group (37 (74%) vs 3 (4.5%), = 0.001). The prevalence of lower parathyroid hormone (PTH) (14 (28%) vs 2 (3%)), testosterone (33 (66%) vs 15 (22.7%)), vitamin D3 (44 (88%) vs 39 (59.1%)), and cortisol (37 (74%) vs 37 (56.1) levels was higher in Frail group ( < 0.05). The number of patients diagnosed with osteodystrophy (34 (68%) vs 21 (31.8%), = 0.001) was significantly higher in Frail group. The marker of osteoclastic activity, β-cross laps, was significantly elevated in the Frail group both in males (736 (655-818) vs 380 (329-432), = 0.001) and (females 619 (479-758) vs 313 (83-543), = 0.02). Bone mineral density (BMD) at lumbar spine (LS) and neck of femur (NF) had significant correlation with LFI (ρ = 0.60, = 0.001 for LS and ρ = 0.59, = 0.001 for NF), serum testosterone (ρ = 0.58, = 0.001 for LS and ρ = 0.53, = 0.001 for NF), β-cross laps (ρ = 0.38, = 0.001for LS and ρ = 0.35, = 0.000 for NF), vitamin D3 (ρ = 0.23, = 0.04 for LS and ρ = 0.25, = 0.01 for NF), PTH (ρ = 0.52, = 0.001 for LS and ρ = 0.48. = 0.001 for NF), and cortisol (ρ = 0.50, = 0.001 for LS and ρ = 0.45, = 0.001 for NF) levels.

Conclusion: This is the first study that highlights the high prevalence of hormonal changes and hepatic osteodystrophy in frail patients with cirrhosis and opens a new dimension for research and target of therapy in this field.

Citing Articles

Longitudinal changes in bone mineral density may be associated with long-term survival in patients with cirrhosis: A proof of concept of study.

Agarwal S, Sharma S, Grover I, Singh N, Ahmed S, Saraya A Indian J Gastroenterol. 2024; 43(4):775-784.

PMID: 38619809 DOI: 10.1007/s12664-023-01504-y.

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