• T CHUGHTAI Department of Medicine, Nishtar Medical University and Hospital (NMU&H), Multan, Pakistan
  • AR KHAN Department of Medicine, Nishtar Medical University and Hospital (NMU&H), Multan, Pakistan
  • A RAZA Department of Gastroenterology, Nishtar Medical University and Hospital (NMU&H), Multan, Pakistan




Osteoporosis, Chronic liver disease, liver transplant, , bone mineral density


A prospective study was conducted in Nishtar Medical Hospital from January 2022 to January 2023 to assess the incidence of osteoporosis before liver transplant in patients with chronic liver disease. A total of 70 patients were included in the study. A liver biopsy was used to confirm the hepatological diagnosis. Dual-energy X-ray absorptiometry through a densitometer was used for measuring bone mineral density. Results showed that the prevalence of osteoporosis at the femoral neck and lumbar spine was 37%, and in only 14.3% of cases, bone density at these sites was normal. More patients had osteopenia and osteoporosis at the femoral neck (41.7%) compared to the lumbar spine (24.2%) (P=0.009). Osteoporosis was not associated with the severity of the disease; its prevalence was 39%, 32%, and 36% in those with Child-Pugh A, B, and C, respectively (P=0.78). Lower weight (P=0.0007) and increasing age (P=0.038) were independent risk factors for osteoporosis during chronic liver disease. Results show that osteoporosis is highly prevalent in subjects with chronic liver disease before a liver transplant score.


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Barchetta, I., Lubrano, C., Cimini, F. A., Dule, S., Passarella, G., Dellanno, A., Di Biasio, A., Leonetti, F., Silecchia, G., and Lenzi, A. (2022). Liver fibrosis is associated with impaired bone mineralization and microstructure in obese individuals with non-alcoholic fatty liver disease. Hepatology International, 1-10.

Carey, J. J., Wu, P. C.-H., and Bergin, D. (2022). Risk assessment tools for osteoporosis and fractures in 2022. Best Practice & Research Clinical Rheumatology, 101775.

Cherukuri, L., Kinninger, A., Birudaraju, D., Lakshmanan, S., Li, D., Flores, F., Mao, S. S., and Budoff, M. J. (2021). Effect of body mass index on bone mineral density is age-specific. Nutrition, Metabolism and Cardiovascular Diseases 31, 1767-1773.

Daley, T., Hughan, K., Rayas, M., Kelly, A., and Tangpricha, V. (2019). Vitamin D deficiency and its treatment in cystic fibrosis. Journal of Cystic Fibrosis 18, S66-S73.

Danford, C. J., Trivedi, H. D., and Bonder, A. (2020). Bone health in patients with liver diseases. Journal of clinical densitometry 23, 212-222.

Jadzic, J., Cvetkovic, D., Tomanovic, N., Zivkovic, V., Nikolic, S., Milovanovic, P., Djuric, M., and Djonic, D. (2021). The severity of hepatic disorder is related to vertebral microstructure deterioration in cadaveric donors with liver cirrhosis. Microscopy Research and Technique 84, 840-849.

Jeong, H. M., and Kim, D. J. (2019). Bone diseases in patients with chronic liver disease. International Journal of Molecular Sciences 20, 4270.

Li, X. Y., Lew, C. C. H., and Kek, P. C. (2021). Bone mineral density following liver transplantation: a 10-year trend analysis. Archives of Osteoporosis 16, 1-7.

Linares, I., Hamar, M., Selzner, N., and Selzner, M. (2019). Steatosis in liver transplantation: current limitations and future strategies. Transplantation 103, 78-90.

Loomes, K. M., Spino, C., Goodrich, N. P., Hangartner, T. N., Marker, A. E., Heubi, J. E., Kamath, B. M., Shneider, B. L., Rosenthal, P., and Hertel, P. M. (2019). Bone density in children with chronic liver disease correlates with growth and cholestasis. Hepatology 69, 245-257.

Loosen, S. H., Roderburg, C., Demir, M., Qvartskhava, N., Keitel, V., Kostev, K., and Luedde, T. (2022). Non-alcoholic fatty liver disease (NAFLD) is associated with an increased incidence of osteoporosis and bone fractures. Zeitschrift für Gastroenterologie 60, 1221-1227.

Pedersen, M. R., and Mayo, M. J. (2020). Managing the symptoms and complications of cholestasis. Clinical liver disease 15, 120.

Pravisani, R., Soyama, A., Isola, M., Sadykov, N., Takatsuki, M., Hidaka, M., Adachi, T., Ono, S., Hara, T., and Hamada, T. (2019). Chronological changes in skeletal muscle mass following living‐donor liver transplantation: an analysis of the predictive factors for long‐term post‐transplant low muscularity. Clinical Transplantation 33, e13495.

Rodríguez-Aguilar, E. F., Pérez-Escobar, J., Herrera, D. S., García-Alanis, M., Toapanta-Yanchapaxi, L., Gonzalez-Flores, E., and García-Juárez, I. (2021). Bone disease and liver transplantation: a review. In "Transplantation Proceedings", Vol. 53, pp. 2346-2353. Elsevier.

Schmidt, T., Schmidt, C., Strahl, A., Mussawy, H., Rolvien, T., Jandl, N. M., Casar, C., Oheim, R., Schinke, T., and Lohse, A. W. (2020). A system to determine risk of osteoporosis in patients with autoimmune hepatitis. Clinical Gastroenterology and Hepatology 18, 226-233. e3.

Yang, Y. J., and Kim, D. J. (2021). An overview of the molecular mechanisms contributing to musculoskeletal disorders in chronic liver disease: osteoporosis, sarcopenia, and osteoporotic sarcopenia. International Journal of Molecular Sciences 22, 2604.

Zavatta, G., and Clarke, B. L. (2021). Glucocorticoid-and transplantation-induced osteoporosis. Endocrinology and Metabolism Clinics 50, 251-273.




How to Cite

CHUGHTAI, T., KHAN, A., & RAZA, A. (2023). HIGH INCIDENCE OF OSTEOPOROSIS IN CHRONIC LIVER DISEASE BEFORE LIVER TRANSPLANTATION. Biological and Clinical Sciences Research Journal, 2023(1), 221. https://doi.org/10.54112/bcsrj.v2023i1.221

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