Ekta Yadava, Rupan Deep Kaurb, Aayushi Sasanc, Sunny Gargd*
aDepartment of Medicine, Bhagat Phool Singh Government Medical College for Women Sonipat, Haryana, India, bDepartment of Transfusion Medicine, Bhagat Phool Singh Government Medical College for Women, Sonipat, Haryana, India, cBhagat Phool Singh Government Medical College for Women, Sonipat, Haryana, India, dDepartment of Psychiatry, Bhagat Phool Singh Government Medical College for Women, Sonipat, Haryana, India
Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation
Abstract
Objectives: Hepatic osteodystrophy (HOD) is a well‑recognized complication of chronic liver diseases (CLD), but the influential factors associated with this complication were studied scarcely in a rural Indian population. The study aims to evaluate the prevalence of HOD and variables that might influence it among cases diagnosed with CLD. Materials and Methods: It is a cross‑sectional observational design survey that was performed in a hospital among the two‑hundred cases and controls with a 1:1 ratio who were age (>18 years) and gender matched in a period between April and October 2021. They were subjected to etiological workup, hematological and biochemical investigations, and Vitamin D levels. Then, dual‑energy X‑ray absorptiometry was used to measure the bone mineral densitometry (BMD) for whole‑body, lumbar spine (LS), and hip. HOD was diagnosed according to the WHO criteria. Then, the Chi‑square test and conditional logistic regression analysis were used to investigate the influential factors of HOD in CLD patients. Results: The whole‑body, LS‑spine, and hip BMDs in CLD cases were found to be significantly lower as compared to controls. When the participants among both groups were stratified by age and gender, a significant difference in LS‑spine and hip BMD was observed in elderly patients (>60 years), and in both the male and female patients. HOD was found in 70% of CLD patients. After multivariate analysis in CLD patients, we identified that being a male patient (odds ratio [OR] = 3.03), older age (OR = 3.54), duration of illness for more than 5 years (OR = 3.89), decompensated liver dysfunction with Child–Turcotte–Pugh‑B and C grading (OR = 8.28), and low level of Vitamin D (OR = 18.45) were the risk factors for HOD. Conclusion: This study concludes that severity of illness and lower level of Vitamin D were the main influential factors for HOD. Supplementation of Vitamin D and calcium in the patients can abate the risk of fractures in our rural communities.
Keywords: Bone mineral density, Chronic liver disease, Hepatic osteodystrophy, Risk factorsmagnitude
