Clinical Indicators of Bone Deterioration in Alcoholic Liver Cirrhosis and Chronic Alcohol Abuse: Looking beyond Bone Fracture Occurrence
Although previous studies indicated that chronic alcohol abuse (CAA) and alcoholic liver cirrhosis (ALC) are associated with increased bone fragility, understanding bone fragility determinants is still modest in these individuals. We used a comprehensive individualized clinical fracture risk assessm...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-02-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/14/5/510 |
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| author | Milos Stulic Jelena Jadzic Natasa Dostanic Milica Zivkovic Tihomir Stojkovic Jelena Aleksic Stefan Stojkovic Milica Stojkovic Lalosevic Marko Vojnovic Zeljko Vlaisavljevic Jelena Martinov Nestorov Tatjana Nikolić Violeta Culafic Vojinovic Djordje Culafic Danijela Djonic |
| author_facet | Milos Stulic Jelena Jadzic Natasa Dostanic Milica Zivkovic Tihomir Stojkovic Jelena Aleksic Stefan Stojkovic Milica Stojkovic Lalosevic Marko Vojnovic Zeljko Vlaisavljevic Jelena Martinov Nestorov Tatjana Nikolić Violeta Culafic Vojinovic Djordje Culafic Danijela Djonic |
| author_sort | Milos Stulic |
| collection | DOAJ |
| description | Although previous studies indicated that chronic alcohol abuse (CAA) and alcoholic liver cirrhosis (ALC) are associated with increased bone fragility, understanding bone fragility determinants is still modest in these individuals. We used a comprehensive individualized clinical fracture risk assessment approach (vertebral osteodensitometry, femoral osteodensitometry and geometry, and serum bone turnover biomarkers) to compare adult male patients with ALC who have not previously had femoral or vertebral fractures (<i>n</i> = 39), patients with CAA (without liver cirrhosis, <i>n</i> = 78) who have not previously had femoral or vertebral fractures and healthy age- and sex-matched controls (<i>n</i> = 43). Our data suggested that intertrochanteric bone mineral density was significantly lower in ALC and CAA patients than in controls. Also, the trabecular bone score was considerably lower in ALC patients compared with CAA and control individuals. The most significant inter-group differences in femoral geometry were noted on the femoral shaft. Patients with ALC and CAA have a higher 10-year risk of major osteoporotic fractures compared to the controls. Analysis of bone turnover biomarkers showed increased osteoprotegerin and beta-C-terminal telopeptide serum concentrations and decreased insulin growth factor-1 concentrations in patients with ALC compared to CAA and control groups. Our data revealed that bone alterations are present in patients with ALC and CAA even if they did not sustain a nontraumatic bone fracture, but it is also indicative that current bone-assessing clinical methods are not entirely reliable. Thus, future studies should focus on developing a reliable integrative clinical tool that can be used to accurately predict and prevent bone fracture occurrences in patients with ALC and CAA. |
| first_indexed | 2024-04-25T00:32:50Z |
| format | Article |
| id | doaj.art-fca5f7daa5f843dab5d4823eff74c8ff |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-04-25T00:32:50Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-fca5f7daa5f843dab5d4823eff74c8ff2024-03-12T16:42:00ZengMDPI AGDiagnostics2075-44182024-02-0114551010.3390/diagnostics14050510Clinical Indicators of Bone Deterioration in Alcoholic Liver Cirrhosis and Chronic Alcohol Abuse: Looking beyond Bone Fracture OccurrenceMilos Stulic0Jelena Jadzic1Natasa Dostanic2Milica Zivkovic3Tihomir Stojkovic4Jelena Aleksic5Stefan Stojkovic6Milica Stojkovic Lalosevic7Marko Vojnovic8Zeljko Vlaisavljevic9Jelena Martinov Nestorov10Tatjana Nikolić11Violeta Culafic Vojinovic12Djordje Culafic13Danijela Djonic14Clinic for Gastroenterohepatology, University Clinical Center of Serbia, 11000 Belgrade, SerbiaCenter of Bone Biology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaSpecial Hospital for Addiction Diseases “Drajzerova”, 11000 Belgrade, SerbiaInstitute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaInstitute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaInstitute for Health Protection of Workers of Serbian Railways, 11000 Belgrade, SerbiaClinic for Gastroenterohepatology, University Clinical Center of Serbia, 11000 Belgrade, SerbiaClinic for Gastroenterohepatology, University Clinical Center of Serbia, 11000 Belgrade, SerbiaClinic for Gastroenterohepatology, University Clinical Center of Serbia, 11000 Belgrade, SerbiaClinic for Gastroenterohepatology, University Clinical Center of Serbia, 11000 Belgrade, SerbiaClinic for Gastroenterohepatology, University Clinical Center of Serbia, 11000 Belgrade, SerbiaInstitute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaEuromedik Hospital, 11000 Belgrade, SerbiaClinic for Gastroenterohepatology, University Clinical Center of Serbia, 11000 Belgrade, SerbiaCenter of Bone Biology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaAlthough previous studies indicated that chronic alcohol abuse (CAA) and alcoholic liver cirrhosis (ALC) are associated with increased bone fragility, understanding bone fragility determinants is still modest in these individuals. We used a comprehensive individualized clinical fracture risk assessment approach (vertebral osteodensitometry, femoral osteodensitometry and geometry, and serum bone turnover biomarkers) to compare adult male patients with ALC who have not previously had femoral or vertebral fractures (<i>n</i> = 39), patients with CAA (without liver cirrhosis, <i>n</i> = 78) who have not previously had femoral or vertebral fractures and healthy age- and sex-matched controls (<i>n</i> = 43). Our data suggested that intertrochanteric bone mineral density was significantly lower in ALC and CAA patients than in controls. Also, the trabecular bone score was considerably lower in ALC patients compared with CAA and control individuals. The most significant inter-group differences in femoral geometry were noted on the femoral shaft. Patients with ALC and CAA have a higher 10-year risk of major osteoporotic fractures compared to the controls. Analysis of bone turnover biomarkers showed increased osteoprotegerin and beta-C-terminal telopeptide serum concentrations and decreased insulin growth factor-1 concentrations in patients with ALC compared to CAA and control groups. Our data revealed that bone alterations are present in patients with ALC and CAA even if they did not sustain a nontraumatic bone fracture, but it is also indicative that current bone-assessing clinical methods are not entirely reliable. Thus, future studies should focus on developing a reliable integrative clinical tool that can be used to accurately predict and prevent bone fracture occurrences in patients with ALC and CAA.https://www.mdpi.com/2075-4418/14/5/510alcoholic liver cirrhosischronic alcohol abuseosteoporosisFRAXtrabecular bone scoredual-energy x-ray absorptiometry (DXA) |
| spellingShingle | Milos Stulic Jelena Jadzic Natasa Dostanic Milica Zivkovic Tihomir Stojkovic Jelena Aleksic Stefan Stojkovic Milica Stojkovic Lalosevic Marko Vojnovic Zeljko Vlaisavljevic Jelena Martinov Nestorov Tatjana Nikolić Violeta Culafic Vojinovic Djordje Culafic Danijela Djonic Clinical Indicators of Bone Deterioration in Alcoholic Liver Cirrhosis and Chronic Alcohol Abuse: Looking beyond Bone Fracture Occurrence Diagnostics alcoholic liver cirrhosis chronic alcohol abuse osteoporosis FRAX trabecular bone score dual-energy x-ray absorptiometry (DXA) |
| title | Clinical Indicators of Bone Deterioration in Alcoholic Liver Cirrhosis and Chronic Alcohol Abuse: Looking beyond Bone Fracture Occurrence |
| title_full | Clinical Indicators of Bone Deterioration in Alcoholic Liver Cirrhosis and Chronic Alcohol Abuse: Looking beyond Bone Fracture Occurrence |
| title_fullStr | Clinical Indicators of Bone Deterioration in Alcoholic Liver Cirrhosis and Chronic Alcohol Abuse: Looking beyond Bone Fracture Occurrence |
| title_full_unstemmed | Clinical Indicators of Bone Deterioration in Alcoholic Liver Cirrhosis and Chronic Alcohol Abuse: Looking beyond Bone Fracture Occurrence |
| title_short | Clinical Indicators of Bone Deterioration in Alcoholic Liver Cirrhosis and Chronic Alcohol Abuse: Looking beyond Bone Fracture Occurrence |
| title_sort | clinical indicators of bone deterioration in alcoholic liver cirrhosis and chronic alcohol abuse looking beyond bone fracture occurrence |
| topic | alcoholic liver cirrhosis chronic alcohol abuse osteoporosis FRAX trabecular bone score dual-energy x-ray absorptiometry (DXA) |
| url | https://www.mdpi.com/2075-4418/14/5/510 |
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