FREQUENCY OF OSTEOPOROSIS IN PATIENTS WITH CIRRHOSIS DUE TO HEPATITIS B AND HEPATITIS C: A STUDY OF 100 CASES
AbstractBackground: Osteoporosis is the disease of bone that affected King David of Israel 3000 years ago.This condition is no longer considered to be due to aging alone and is increasingly recognised as amajor health concern and accounts for about 1.5 million fractures annually in United States. Objectiveof this study was to see the frequency of osteoporosis in patients with cirrhosis due to Hepatitis B andC, and any correlation between the Bone Mineral Density (BMD) and duration and stage of the liverdisease. Methods: The study was conducted in the Department of Gastroenterology, PostgraduateMedical Institute, Hayatabad Medical Complex, Peshawar, from January 2008 to December 2008. Allpatients from the OPD or Ward fulfilling the criteria and consenting were included. Physicalexamination, with special emphasis on any signs of chronic liver disease was performed. Full bloodcount, platelet count, prothrombin time and INR, liver function tests including serum albumin, andrenal function tests were done on all patients. Viral serology was checked for those patients who wereeither newly diagnosed as cirrhotic or were cirrhotic but not screened for viral markers. Abdominalsonogram was recorded on all patients. The Child’s score was calculated for each patient using theclinical and lab parameters. The BMD was calculated for all patients using computer based ultrasoundprobe. Calcaneum was used for evaluation of BMD. The information collected was entered onstructured data collection sheets and was analysed using SPSS version 11. Results: Osteoporosis wasfound in 26% of subject and osteopenia in 42%, while 32% had BMD in the normal range. The mean Tscore was -1.483 (±1.29). The mean duration of liver disease was 3.77 (±1.56) year. Majority of thepatients (81%) were in Child’s Class C, followed by Class B and A (16% and 3% respectively). Fiftynine percent of the patients were males with a mean age of 37.65 years, while 41% were females withmean age of 37.76 years. Conclusion: Osteoporosis is a common finding in patients with cirrhosis dueto Hepatitis B and C. Osteoporosis is more frequent in patients with long duration of liver disease butthere is no significant correlation between the aetiology or severity of liver disease and osteoporosis.Keywords: BMD, T score, Child’s score, Cirrhosis, Hepatitis B, Hepatitis C, Osteoporosis
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