AMOUNT AND COMPOSITION OF BONE MINERALS IN CHRONIC LIVER-DISEASE

Alterations in bone mineral are a common complication of chronic liver disease. The aim of the current study was to assess bone mineral stat us in patients with chronic liver disease not treated with corticoster oids and to investigate any possible correlation with the histological stage of the liver disease. Bone mineral status in 27 patients with c hronic active hepatitis, and 17 with active cirrhosis was compared to that of matched controls. Partial body neutron activation analysis was applied for measuring hand bone phosphorus, single-photon absorptiome try for measuring forearm bone mineral content, and dual-energy x-ray absorptiometry for measuring spinal bone mineral density. These noninv asive measurements were supplemented with data obtained by high resolu tion radiography and biochemistry. Decreased metacarpal cortical thick ness was found in five patients, all in the cirrhotic group, In additi on, both mean intact parathyroid hormone and 25-hydroxyvitamin D level s were reduced in this group of patients. The mean values of the quant ities assessed by the in vivo techniques in patients in the early stag es of the hepatic disease did not differ statistically from those of m atched normal controls. On the contrary, these quantities were reduced by 9% in the patients at the late stages relative to controls. In con clusion, only the late stages of liver disease are associated with an increased risk of fractures.