Adeel Ahmed, Sobia Mehreen, Muhammad Tahir, Afeera Afsheen.
Osteoporosis in chronic liver disease (CLD).
Pak Armed Forces Med J Jan ;68(4):846-9.

Objective:  To find the frequency of osteoporosis in male patients with cirrhosis secondary to hepatitis C and its relation with Child Pugh score of liver cirrhosis in outpatient department of CMH Kohat.  Study Design:  Descriptive cross sectional study. Place and Duration of Study:  Combined Military Hospital Kohat, from Dec 2012 to Jun 2013.  Material and Method:  A total of 94 patients (47 cases of Child Pugh B and 47 cases of Child Pugh Class C) were included in this study. DEXA scan was done for measuring bone density. Patients were grouped according to their T scores. Frequency of osteoporosis was calculated in both Child Pugh Class B patients and Class C patients and comparison was done using Chi Square test.  Results:  Mean age of the patients was 52.23 ± 8.46 and 55.57 ± 7.43 in Child Pugh Class-B and C class, respectively. Mean BMI in Child Pugh Class-B was 20.69 ± 3.77 and in class C it was 20.50 ± 3.99. Bone metabolic changes were found in 20 cases of Child Pugh Class-B, out of these 20 cases, 12 (25.5%) had osteopenia and 8 (17.0%) had osteoporosis. Bone metabolic changes were found in 34 cases of Child Pugh Class-C. Out of these 34 cases 22 (46.8%) had osteopenia and 12 (25.5%) had Osteoporosis.  Conclusion:  There is higher prevalence of osteoporosis in patients with cirrhosis. In these patients’s osteoporosis must be diagnosed early and treated appropriately particularly when risk factors such as severe liver disease, low BMI and cholestasis are present.      

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