Metabolic bone disease is a complication of chronic liver disease (CLD) and is well known as “hepatic osteodistrophy”. Osteoporosis accounts for the majority of cases, whereas osteomalacia is rare in the absence of advanced liver disease and severe malabsorption. The prevalence is the same in men and women, however the published prevalence of osteoporosis considerably differs and ranges from 20% to 100%, depending on patients selection and different diagnostic criteria. Many reports are referred to a broad spectrum of liver disease of different aetiology and severity: in patients with advanced liver disease candidates for or treated with orthotopic liver transplantation, osteoporosis is prevalent and contributes to a major source of morbidity preceding and following transplantation. Nevertheless, little is known about the prevalence among patients with non-advanced liver disease. The aetiology and pathogenesis of osteoporosis in these patients also remain undefined, even though its histology is quite similar to post-menopausal and age-related bone loss, affecting trabecular bone more rapidly than cortical bone. Finally, there is controversy about risk factors for osteoporosis in CLD: liver cirrhosis, cholestasis, hypogonadism, corticosteroid or immuno- suppressive treatment, alcohol consumption, malnutrition and malabsorption, sex, physical activity, subnormal vitamin D levels and/or vitamin D receptor genotype, insulin growth factor 1 (IGF-1) deficiency, as well as country and nationality are all reported factors affecting bone metabolism. However, whether non-advanced liver disease “per se” could be a risk factor for osteoporosis still remains uncertain; moreover there are few reports about the effects of viral liver disease on bone turnover.
Aim of this study was to evaluate bone mineral density (BMD) and bone metabolism markers in a selected series of male patients living in the same geographical area of Southern Italy, affected only by viral, non-advanced chronic liver disease, as compared to a randomly selected control group from the same geographical area. Going without your pills? where to buy cialis