THE CLINICAL IMPORTANCE OF BIOCHEMICAL BONE MARKERS IN PATIENTS WITH ALCOHOLIC AND VIRAL LIVER CIRRHOSIS / KLINI?KI ZNA?AJ BIOHEMIJSKIH KO?TANIH MARKERA KOD PACIJENATA SA ALKOHOLNOM I VIRUSNOM CIROZOM JETRE

摘要

SummaryBackground Metabolic bone disease in patients with chronic liver disease is called hepatic osteodystrophy and is primarily a sequel to osteopenia/osteoporosis, and rarely secondary to osteomalacia. The aim of this work was to define the influence of vitamin D3 and parathyroid hormone (PTH) in the pathogenesis of hepatic osteodystrophy, as well as the predictive significance of biochemical bone markers. MethodsThis prospective study included 58 male patients with alcoholic (49) and viral (9) cirrhosis. The concentrations of serum vitamin D3, PTH, osteocalcin and b-carboxy-ter - minal cross-linked telopeptide of type I collagen (b-CTX) were determined. Bone density was measured by dual energy X-ray absorptiometry in the L1-L4 spinal segment and the femoral neck.Results Lower bone mineral density (BMD) was measured in 41 patients (70.7%). There was no significant correlation between PTH and vitamin D3 values and T score in the femoral neck (p=0.51; p=0.063) and lumbar spine (p=0.49; 0.064). Also, no significant correlation was found between the osteocalcin values in lumbar spine BMD (p=0.944) and femoral neck (p=0.161), or with b-CTX values and BMD in the lumbar spine (p=0.347) and femoral neck (p=0.73). Statistically significant difference was confirmed between the stage A osteocalcin (p=0.000) and b- CTX (p=0.008) values in relation to advanced stages B and C.