Abstract:
:Chronic liver disease in adults is a risk factor of osteoporosis, but little is known about risk of fractures in children with non-cholestatic liver disease. The aim of this study was to investigate associations among the severity of liver fibrosis, bone mass and low-energy fractures in children. History of fractures, anthropometry, and bone mass and size were examined in 39 Caucasian children (25 boys, 14 girls) aged 7.1-18 years (mean 11.9 ± 3.1) with chronic hepatitis B and liver fibrosis evidenced by liver biopsy. Severity of liver fibrosis was based on histological classification according to the method of Batts and Ludwig (mild, 1-2 scores; advanced, 3 scores) and Ishak (1-3 and 4-5 scores, respectively). Bone mineral content (BMC), density (BMD) and body composition were determined in the total body and lumbar spine using dual energy X-ray absorptiometry. Seven subjects (4 girls, 3 boys; 18% of the sample) had low BMD in the total body and lumbar spine region (Z-scores below -2.0). No associations were found among BMC, BMD, bone size and the severity of liver fibrosis. Nine boys (36% of all boys) and one girl reported repeated fractures (forearm, wrist, tibia, ankle, humerus), showing trends similar to the prevalence in general population. Fractures were neither associated with lower BMD/BMC nor with scores of liver fibrosis. Deficits in BMD in children with chronic hepatitis B are not associated with the severity of liver fibrosis. This study suggests that non-cholestatic liver disease does not increase the risk of low-energy fractures during growth. From the practical perspective, however, children with chronic liver disease should be screened for history and clinical risk factors for fractures rather than referred to bone density testing.
journal_name
J Bone Miner Metabjournal_title
Journal of bone and mineral metabolismauthors
Konstantynowicz J,Lebensztejn DM,Skiba E,Sobaniec-Lotowska ME,Abramowicz P,Piotrowska-Jastrzebska J,Kaczmarski Mdoi
10.1007/s00774-010-0219-7subject
Has Abstractpub_date
2011-05-01 00:00:00pages
315-20issue
3eissn
0914-8779issn
1435-5604journal_volume
29pub_type
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doi:10.1007/s00774-010-0202-3
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journal_title:Journal of bone and mineral metabolism
pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2008-01-01 00:00:00
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pub_type: 杂志文章
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