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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Veröffentlicht in:Osteoporosis international 2000-05, Vol.11 (5), p.417-424
Hauptverfasser: 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
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container_title Osteoporosis international
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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
doi_str_mv 10.1007/s001980070109
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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&amp;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. 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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. 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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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