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THE EFFECT OF CHRONIC VIRAL HEPATITIS B AND C ON BONE MINERAL DENSITY
Objectives. Chronic viral hepatitis B and C represent an important health burden all over the world. Reduced bone mineral density is an extrahepatic complication which has been found in patients with chronic liver disease. The aim of our study was to identify bone mineral impairment (osteopenia/osteoporosis) and the risk factors that are correlated with its severity, in patients with chronic viral hepatitis B (CHB) and C (CHC).
Material and methods. Anthropometric, biological parameters and bone mineral density (BMD) were measured in 60 patients with CHB (n = 30) and CHC (n = 30). BMD was assessed using Dual Energy X-ray Absorptiometry (DEXA) in the hip and lumbar spine regions, inclusively a whole scan (total body).
Results. Sixty patients (mean age 44.93 years, range: 20-70) were enrolled, including 30 CHB patients (mean age 46.43 years, range: 20-70) and 30 CHC patients (mean age 43.43 years, range: 28-64). Forty of
patients were men (66.66 %). Active smokers were 16 patients (26.66 %). Meanbody mass index (BMI) was 25.38 kg/m2 (range: 16.70-38.40). At baseline, 21 of 60 (35%) of the patients had evidence of osteopenia and 4 of 60 (6.66%) of patients, respectively presented osteoporosis at LS. At total hip, 22 of 60 of the patients (36.66%) recorded osteopenia; osteoporosis was found at 7 patients (11.66%) at total hip assessment. Low BMD values at different regions correlated significantly with low BMI, smoking and liver fibrosis grade.
Conclusions. Our results suggest that bone mineral metabolism disorders exist in patients with chronic viral hepatitis B and C who are active smokers, presenting low BMI and advanced liver fibrosis, even without liver cirrhosis.
Keywords: osteodystrophy, osteoporosis, chronic viral hepatitis B, chronic viral hepatitis C, chronic liver disease, bone mineral density