Osteoporosis is a major cause of morbidity in liver transplant recipients. It is associated with multiple factors.
In this study, researchers from Israel evaluated bone mineral density (BMD), bone turnover and calcium-regulating hormones in 29 patients. Patients were assessed 2 to 12 years after liver transplantation for non-alcoholic liver disease.
Of the 29 patients, 15 were on immunosuppressive treatment with tacrolimus, and 14 with cyclosporine.
|19 of 29 patients had decreased bone mineral density.|
Overall, 11 patients were on prednisone, while 18 patients had stopped glucocorticoid treatment 6 months to 11 years prior to the study.
The team found that 19 patients had decreased BMD according to WHO criteria, 17 at the femoral neck and 13 at the lumbar spine.
Furthermore, 19 patients had a subnormal (<15 ng/ml) serum level of 25 (OH) D3. These patients had significantly lower BMD at the femoral neck.
The team determined that femoral neck BMD negatively correlated with serum parathyroid hormone level, length of the post-transplantation period, and duration of glucocorticoid treatment, regardless of its cumulative dose.
They also found that symptomatic fractures were less frequent in tacrolimus treated patients, than in cyclosporine users.
Dr Elena Segala’s team concluded, “Decreased BMD is frequent following liver transplantation and is affected by vitamin D deficiency, cyclosporine use, and the duration of glucocorticoid therapy, but not by its cumulative dose”.
“Achievement and maintenance of optimal vitamin D status and shortening of glucocorticoid treatment period may have a favorable effect on bone preservation.”