CHANGES IN BONE MASS IN HEPATIC CIRRHOSIS, CHRONIC OBSTRUCTIVE PULMONARY-DISEASE, INSULIN-DEPENDENT DIABETES AND PRIMARY HYPERPARATHYROIDISM

BACKGROUND: Liver cirrhosis, chronic obstructive pulmonary disease (CO PD), insulindependent diabetes mellitus and primary hyperparathyroidis m are frequent diseases which are considered as risk factors for the d evelopment of osteoporosis. However, review of the literature has show n that the studies published on the aformentioned are far from conclus ive. METHODS: By double energy X-ray absorptiometry the bone mineral d ensity (BMD) of the lumbar spine and neck of the femur were determined in 29 patients with liver cirrhosis, 92 with chronic obstructive pulm onary disease (59 treated with corticoids), 81 with insulindependent d iabetes mellitus and 30 primary hyperparathyroidism (7 operated). RESU LTS: Cirrhotic patients had a normal BMD in both localizations. In pat ients with COPD, without corticoids, a decrease of 6 % was found in th e spine and or 13.5 % in the neck of the femur while in patients with COPD with corticoids the decrease was of 12 % and 7 % respectively. Di abetic patients had normal BMD in the spine and a decrease of 6 % in t he neck of the femur and in patients with hyperparathyroidism a decrea se of 6 % and normality were found, respectively. CONCLUSIONS: The rep ercussion of cirrhosis, insulinodependent diabetes, and primary hyperp arathyroidism on bone mineral density is nul or slight. In patients wi th chronic obstructive pulmonary disease treated with corticoids decre ase in density of the spine is approximately that of a standard deviat ion. In patients with the latter not treated with corticoids a similar decrease is found in the neck of the femur.