Bone Mineral Density and Serum Levels of Soluble Tumor Necrosis Factors, Estradiol, and Osteoprotegerin in Postmenopausal Women with Cirrhosis after Viral Hepatitis
Bone Mineral Density and Serum Levels of Soluble Tumor Necrosis Factors, Estradiol, and Osteoprotegerin in Postmenopausal Women with Cirrhosis after Viral Hepatitis
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DOI：
10.1210/jc.2009-0835
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发表时间：
2009-12-01
影响因子：
5.8
通讯作者：
Martin-Ibanez, Jose J.
中科院分区：
文献类型：
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作者：
Gonzalez-Calvin, Jorge L.;Mundi, Jose L.;Martin-Ibanez, Jose J.
背景：病毒性肝炎后肝硬化已被确定为男性骨质疏松症的危险因素。然而，在绝经后妇女中，大多数研究评估了原发性胆汁性肝硬化的影响，但对病毒性肝硬化对骨量[骨矿物质密度（BMD）]和骨代谢的影响知之甚少。目的：我们的目的是评估病毒性肝硬化对绝经后妇女BMD和骨代谢的影响。设计：我们进行了一项横断面描述性研究。我们研究了84名绝经后女性门诊患者与病毒性肝硬化和96名健康绝经后妇女从一般社区。采用双能X线骨密度仪测量腰椎（LS）和股骨颈（FN）的骨密度。结果：患者（LS，43.1%; FN，32.2%）和对照组（LS，41.2%; FN，29.4%）之间骨质疏松症的百分比无显著差异。两组之间的骨密度（z评分）无差异。患者血清可溶性TNF受体、雌二醇和骨保护素（OPG）浓度显著高于对照组（分别为P < 0.001、P < 0.05和P < 0.05）。尿脱氧吡啶啉无显著差异。血清OPG水平与可溶性TNF受体呈正相关（r = 0.35; P < 0.02）和脱氧吡啶啉（r = 0.37; P < 0.05）。这项研究表明，绝经后病毒性肝硬化妇女和健康绝经后对照妇女的骨量和骨吸收率没有差异，并表明病毒性肝硬化似乎不会增加绝经后妇女骨质疏松症的风险。这些女人高血清雌二醇和OPG浓度可能有助于预防绝经后妇女与病毒性肝硬化相关的骨丢失。（临床内分泌代谢杂志94：4844-4850，2009）
Context: Cirrhosis after viral hepatitis has been identified as a risk factor for osteoporosis in men. However, in postmenopausal women, most studies have evaluated the effect of primary biliary cirrhosis, but little is known about the effect of viral cirrhosis on bone mass [bone mineral density (BMD)] and bone metabolism.Objective: Our objective was to assess the effect of viral cirrhosis on BMD and bone metabolism in postmenopausal women.Design: We conducted a cross-sectional descriptive study.Setting and Patients: We studied 84 postmenopausal female outpatients with viral cirrhosis and 96 healthy postmenopausal women from the general community. BMD was measured by dual-energy x-ray absorptiometry at lumbar spine (LS) and femoral neck (FN).Results: The percentage with osteoporosis did not significantly differ between patients (LS, 43.1%; FN, 32.2%) and controls (LS, 41.2%; FN, 29.4%), and there was no difference in BMD (z-score) between groups. Serum concentrations of soluble TNF receptors, estradiol, and osteoprotegerin (OPG) were significantly higher in patients vs. controls (P < 0.001, P < 0.05, and P < 0.05, respectively). No significant difference was observed in urinary deoxypyridinoline. Serum OPG levels were positively correlated with soluble TNF receptors (r = 0.35; P < 0.02) and deoxypyridinoline (r = 0.37; P < 0.05).Conclusions: This study shows that bone mass and bone resorption rates do not differ between postmenopausal women with viral cirrhosis and healthy postmenopausal controls and suggests that viral cirrhosis does not appear to increase the risk of osteoporosis in these women. High serum estradiol and OPG concentrations may contribute to preventing the bone loss associated with viral cirrhosis in postmenopausal women. (J Clin Endocrinol Metab 94: 4844-4850, 2009)