Hepatic osteodystrophy: the influence of liver disease and portal hypertension on cytokine activation

Chronic liver disease is frequently complicated by bone disease. The mechan isms leading to bone-loss are unknown but are probably not related to abnor mal vitamin D metabolism. The effects of portal hypertension and porto-syst emic shunting on bone-loss have not been studied. It is postulated that liv er disease, or the complications of liver disease (portal hypertension or p orto-systemic shunting), might be responsible for the activation of cytokin es. It is further postulated that these cytokines might be the final common pathway leading to bone-loss in both parenchymal and cholestatic liver dis orders by modifying osteoblast or osteoclast function. (C) 2000 Harcourt Pu blishers Ltd.