Long-term persistence of low bone density in orthotopic liver transplantation
We determined bone density and metabolism in 46 patients (35 males, 11 females) who had undergone liver transplantation 1-48 months previously. Twenty-one patients were then followed for the next 24 months. At each visit, blood and urine samples for bone and liver metabolism parameters, as well as s...
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creator | GIANNINI, S NOBILE, M CREPALDI, G CIUFFREDA, M IEMMOLO, R. M CARBONARE, L. D MINICUCI, N CASAGRANDE, F DESTRO, C GERUNDA, G. E SARTORI, L |
description | We determined bone density and metabolism in 46 patients (35 males, 11 females) who had undergone liver transplantation 1-48 months previously. Twenty-one patients were then followed for the next 24 months. At each visit, blood and urine samples for bone and liver metabolism parameters, as well as spinal and femoral dual-energy X-ray absorptiometry (DXA) scans, were obtained. Basal spinal and femoral density was low (p < 0.001). Patients with pre-transplant cholestatic diseases had lower spinal density than all the other subjects (p |
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M ; CARBONARE, L. D ; MINICUCI, N ; CASAGRANDE, F ; DESTRO, C ; GERUNDA, G. E ; SARTORI, L</creator><creatorcontrib>GIANNINI, S ; NOBILE, M ; CREPALDI, G ; CIUFFREDA, M ; IEMMOLO, R. M ; CARBONARE, L. D ; MINICUCI, N ; CASAGRANDE, F ; DESTRO, C ; GERUNDA, G. E ; SARTORI, L</creatorcontrib><description><![CDATA[We determined bone density and metabolism in 46 patients (35 males, 11 females) who had undergone liver transplantation 1-48 months previously. Twenty-one patients were then followed for the next 24 months. At each visit, blood and urine samples for bone and liver metabolism parameters, as well as spinal and femoral dual-energy X-ray absorptiometry (DXA) scans, were obtained. Basal spinal and femoral density was low (p < 0.001). Patients with pre-transplant cholestatic diseases had lower spinal density than all the other subjects (p <0.05) and the cumulative methylprednisolone intake was an independent negative predictor of total hip density (p < 0.02). At baseline, urinary hydroxyproline and N-telopeptide were at the upper normal level and decreased only after 24 months of follow-up (p < 0.05). During the first year of follow-up, femoral density decreased (p < 0.05) and a partial recovery was observed for both spine and femur after 24 months. After 12 months, femoral bone density was negatively associated with serum cyclosporin A levels (p < 0.005) and cumulative methylprednisolone intake (p < 0.05), while the percent decrease in spinal density after the first 12 months was negatively predicted by mean daily methylprednisolone intake (p < 0.05). In patients with pre-transplant cholestatic diseases, femoral and spinal density increased after the first (p < 0.05) and second year (p < 0.05), respectively. In patients with previous post-necrotic cirrhosis, femoral density decreased after 12 months (p<0.05) and was still lower than baseline after 24 months (p < 0.05). However, at the end of the study the cumulative percentage of femoral neck osteoporosis was 43%. In conclusion, an elevated prevalence of spinal and femoral osteoporosis is present even many years after liver transplantation, with immunosuppressive treatment and pre-transplant liver disease being the most important pathogenetic factors.]]></description><identifier>ISSN: 0937-941X</identifier><identifier>EISSN: 1433-2965</identifier><identifier>DOI: 10.1007/s001980070109</identifier><identifier>PMID: 10912844</identifier><language>eng</language><publisher>London: Springer</publisher><subject>Adult ; Biological and medical sciences ; Biomarkers - blood ; Bone and Bones - metabolism ; Bone density ; Bone Density - physiology ; Bone diseases ; Cholangitis ; Cross-Sectional Studies ; Diseases of the osteoarticular system ; Drug dosages ; Female ; Femur - physiopathology ; Follow-Up Studies ; Fractures ; Humans ; Immunosuppressive agents ; Immunosuppressive Agents - adverse effects ; Liver cancer ; Liver cirrhosis ; Liver diseases ; Liver Diseases - complications ; Liver Transplantation - physiology ; Liver transplants ; Liver, biliary tract, pancreas, portal circulation, spleen ; Lumbar Vertebrae - physiopathology ; Male ; Medical sciences ; Men ; Metabolism ; methylprednisolone ; Middle Aged ; Osteoporosis ; Osteoporosis - etiology ; Osteoporosis - physiopathology ; Osteoporosis. Osteomalacia. Paget disease ; Pathogenesis ; Postoperative Complications - physiopathology ; Steroids ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Time Factors ; Womens health</subject><ispartof>Osteoporosis international, 2000-05, Vol.11 (5), p.417-424</ispartof><rights>2000 INIST-CNRS</rights><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2000</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-a86b94c6a50dc5b162d485927da1081c92628b8f4b7b373f6e59273568941f2f3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1448169$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10912844$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>GIANNINI, S</creatorcontrib><creatorcontrib>NOBILE, M</creatorcontrib><creatorcontrib>CREPALDI, G</creatorcontrib><creatorcontrib>CIUFFREDA, M</creatorcontrib><creatorcontrib>IEMMOLO, R. M</creatorcontrib><creatorcontrib>CARBONARE, L. D</creatorcontrib><creatorcontrib>MINICUCI, N</creatorcontrib><creatorcontrib>CASAGRANDE, F</creatorcontrib><creatorcontrib>DESTRO, C</creatorcontrib><creatorcontrib>GERUNDA, G. E</creatorcontrib><creatorcontrib>SARTORI, L</creatorcontrib><title>Long-term persistence of low bone density in orthotopic liver transplantation</title><title>Osteoporosis international</title><addtitle>Osteoporos Int</addtitle><description><![CDATA[We determined bone density and metabolism in 46 patients (35 males, 11 females) who had undergone liver transplantation 1-48 months previously. Twenty-one patients were then followed for the next 24 months. At each visit, blood and urine samples for bone and liver metabolism parameters, as well as spinal and femoral dual-energy X-ray absorptiometry (DXA) scans, were obtained. Basal spinal and femoral density was low (p < 0.001). Patients with pre-transplant cholestatic diseases had lower spinal density than all the other subjects (p <0.05) and the cumulative methylprednisolone intake was an independent negative predictor of total hip density (p < 0.02). At baseline, urinary hydroxyproline and N-telopeptide were at the upper normal level and decreased only after 24 months of follow-up (p < 0.05). During the first year of follow-up, femoral density decreased (p < 0.05) and a partial recovery was observed for both spine and femur after 24 months. After 12 months, femoral bone density was negatively associated with serum cyclosporin A levels (p < 0.005) and cumulative methylprednisolone intake (p < 0.05), while the percent decrease in spinal density after the first 12 months was negatively predicted by mean daily methylprednisolone intake (p < 0.05). In patients with pre-transplant cholestatic diseases, femoral and spinal density increased after the first (p < 0.05) and second year (p < 0.05), respectively. In patients with previous post-necrotic cirrhosis, femoral density decreased after 12 months (p<0.05) and was still lower than baseline after 24 months (p < 0.05). However, at the end of the study the cumulative percentage of femoral neck osteoporosis was 43%. In conclusion, an elevated prevalence of spinal and femoral osteoporosis is present even many years after liver transplantation, with immunosuppressive treatment and pre-transplant liver disease being the most important pathogenetic factors.]]></description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Bone and Bones - metabolism</subject><subject>Bone density</subject><subject>Bone Density - physiology</subject><subject>Bone diseases</subject><subject>Cholangitis</subject><subject>Cross-Sectional Studies</subject><subject>Diseases of the osteoarticular system</subject><subject>Drug dosages</subject><subject>Female</subject><subject>Femur - physiopathology</subject><subject>Follow-Up Studies</subject><subject>Fractures</subject><subject>Humans</subject><subject>Immunosuppressive agents</subject><subject>Immunosuppressive Agents - adverse effects</subject><subject>Liver cancer</subject><subject>Liver cirrhosis</subject><subject>Liver diseases</subject><subject>Liver Diseases - complications</subject><subject>Liver Transplantation - physiology</subject><subject>Liver transplants</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Lumbar Vertebrae - physiopathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Men</subject><subject>Metabolism</subject><subject>methylprednisolone</subject><subject>Middle Aged</subject><subject>Osteoporosis</subject><subject>Osteoporosis - etiology</subject><subject>Osteoporosis - physiopathology</subject><subject>Osteoporosis. Osteomalacia. Paget disease</subject><subject>Pathogenesis</subject><subject>Postoperative Complications - physiopathology</subject><subject>Steroids</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Time Factors</subject><subject>Womens health</subject><issn>0937-941X</issn><issn>1433-2965</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqF0c1LHDEYBvAgle669ui1hCJ6mpo3yWSSYxG_YMVLBW9DJpNps8wm0yRr8b83sgvaHvSUQH685HkfhI6AfAdCmrNECChZbgSI2kNz4IxVVIn6E5oTxZpKcXiYoYOUVqQopZrPaFYoUMn5HN0ug_9VZRvXeLIxuZStNxaHAY_hL-6Ct7i3Prn8hJ3HIebfIYfJGTy6RxtxjtqnadQ-6-yCP0T7gx6T_bI7F-j-8uLn-XW1vLu6Of-xrAwnMldaik5xI3RNelN3IGjPZa1o02sgEoyigspODrxrOtawQdiXR1YLWcIMdGALdLqdO8XwZ2NTbtcuGTuWj9iwSa2quWBAyyoW6ORd2RQlag4fQmiEAFGLAr_9B1dhE32J28qSQlABpKBqi0wMKUU7tFN0ax2fWiDtS2_tP70V_3U3dNOtbf9Gb4sq4HgHdDJ6HMrejUuvjnMJQrFnv1Sdiw</recordid><startdate>20000501</startdate><enddate>20000501</enddate><creator>GIANNINI, S</creator><creator>NOBILE, M</creator><creator>CREPALDI, G</creator><creator>CIUFFREDA, M</creator><creator>IEMMOLO, R. 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E</creator><creator>SARTORI, L</creator><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20000501</creationdate><title>Long-term persistence of low bone density in orthotopic liver transplantation</title><author>GIANNINI, S ; NOBILE, M ; CREPALDI, G ; CIUFFREDA, M ; IEMMOLO, R. M ; CARBONARE, L. D ; MINICUCI, N ; CASAGRANDE, F ; DESTRO, C ; GERUNDA, G. E ; SARTORI, L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-a86b94c6a50dc5b162d485927da1081c92628b8f4b7b373f6e59273568941f2f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Bone and Bones - metabolism</topic><topic>Bone density</topic><topic>Bone Density - physiology</topic><topic>Bone diseases</topic><topic>Cholangitis</topic><topic>Cross-Sectional Studies</topic><topic>Diseases of the osteoarticular system</topic><topic>Drug dosages</topic><topic>Female</topic><topic>Femur - physiopathology</topic><topic>Follow-Up Studies</topic><topic>Fractures</topic><topic>Humans</topic><topic>Immunosuppressive agents</topic><topic>Immunosuppressive Agents - adverse effects</topic><topic>Liver cancer</topic><topic>Liver cirrhosis</topic><topic>Liver diseases</topic><topic>Liver Diseases - complications</topic><topic>Liver Transplantation - physiology</topic><topic>Liver transplants</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Lumbar Vertebrae - physiopathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Men</topic><topic>Metabolism</topic><topic>methylprednisolone</topic><topic>Middle Aged</topic><topic>Osteoporosis</topic><topic>Osteoporosis - etiology</topic><topic>Osteoporosis - physiopathology</topic><topic>Osteoporosis. Osteomalacia. Paget disease</topic><topic>Pathogenesis</topic><topic>Postoperative Complications - physiopathology</topic><topic>Steroids</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Time Factors</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GIANNINI, S</creatorcontrib><creatorcontrib>NOBILE, M</creatorcontrib><creatorcontrib>CREPALDI, G</creatorcontrib><creatorcontrib>CIUFFREDA, M</creatorcontrib><creatorcontrib>IEMMOLO, R. M</creatorcontrib><creatorcontrib>CARBONARE, L. D</creatorcontrib><creatorcontrib>MINICUCI, N</creatorcontrib><creatorcontrib>CASAGRANDE, F</creatorcontrib><creatorcontrib>DESTRO, C</creatorcontrib><creatorcontrib>GERUNDA, G. E</creatorcontrib><creatorcontrib>SARTORI, L</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Osteoporosis international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>GIANNINI, S</au><au>NOBILE, M</au><au>CREPALDI, G</au><au>CIUFFREDA, M</au><au>IEMMOLO, R. M</au><au>CARBONARE, L. D</au><au>MINICUCI, N</au><au>CASAGRANDE, F</au><au>DESTRO, C</au><au>GERUNDA, G. E</au><au>SARTORI, L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term persistence of low bone density in orthotopic liver transplantation</atitle><jtitle>Osteoporosis international</jtitle><addtitle>Osteoporos Int</addtitle><date>2000-05-01</date><risdate>2000</risdate><volume>11</volume><issue>5</issue><spage>417</spage><epage>424</epage><pages>417-424</pages><issn>0937-941X</issn><eissn>1433-2965</eissn><abstract><![CDATA[We determined bone density and metabolism in 46 patients (35 males, 11 females) who had undergone liver transplantation 1-48 months previously. Twenty-one patients were then followed for the next 24 months. At each visit, blood and urine samples for bone and liver metabolism parameters, as well as spinal and femoral dual-energy X-ray absorptiometry (DXA) scans, were obtained. Basal spinal and femoral density was low (p < 0.001). Patients with pre-transplant cholestatic diseases had lower spinal density than all the other subjects (p <0.05) and the cumulative methylprednisolone intake was an independent negative predictor of total hip density (p < 0.02). At baseline, urinary hydroxyproline and N-telopeptide were at the upper normal level and decreased only after 24 months of follow-up (p < 0.05). During the first year of follow-up, femoral density decreased (p < 0.05) and a partial recovery was observed for both spine and femur after 24 months. After 12 months, femoral bone density was negatively associated with serum cyclosporin A levels (p < 0.005) and cumulative methylprednisolone intake (p < 0.05), while the percent decrease in spinal density after the first 12 months was negatively predicted by mean daily methylprednisolone intake (p < 0.05). In patients with pre-transplant cholestatic diseases, femoral and spinal density increased after the first (p < 0.05) and second year (p < 0.05), respectively. In patients with previous post-necrotic cirrhosis, femoral density decreased after 12 months (p<0.05) and was still lower than baseline after 24 months (p < 0.05). However, at the end of the study the cumulative percentage of femoral neck osteoporosis was 43%. In conclusion, an elevated prevalence of spinal and femoral osteoporosis is present even many years after liver transplantation, with immunosuppressive treatment and pre-transplant liver disease being the most important pathogenetic factors.]]></abstract><cop>London</cop><pub>Springer</pub><pmid>10912844</pmid><doi>10.1007/s001980070109</doi><tpages>8</tpages></addata></record> |
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subjects | Adult Biological and medical sciences Biomarkers - blood Bone and Bones - metabolism Bone density Bone Density - physiology Bone diseases Cholangitis Cross-Sectional Studies Diseases of the osteoarticular system Drug dosages Female Femur - physiopathology Follow-Up Studies Fractures Humans Immunosuppressive agents Immunosuppressive Agents - adverse effects Liver cancer Liver cirrhosis Liver diseases Liver Diseases - complications Liver Transplantation - physiology Liver transplants Liver, biliary tract, pancreas, portal circulation, spleen Lumbar Vertebrae - physiopathology Male Medical sciences Men Metabolism methylprednisolone Middle Aged Osteoporosis Osteoporosis - etiology Osteoporosis - physiopathology Osteoporosis. Osteomalacia. Paget disease Pathogenesis Postoperative Complications - physiopathology Steroids Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Time Factors Womens health |
title | Long-term persistence of low bone density in orthotopic liver transplantation |
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