Osteoporosis and Fragility Fractures in Patients With Cirrhosis Evaluated for Liver Transplantation: Identification of High-Risk Patients Based on Computed Tomography at Evaluation.
Journal
The American journal of gastroenterology
ISSN: 1572-0241
Titre abrégé: Am J Gastroenterol
Pays: United States
ID NLM: 0421030
Informations de publication
Date de publication:
10 Nov 2023
10 Nov 2023
Historique:
received:
01
03
2023
accepted:
04
08
2023
pubmed:
22
9
2023
medline:
22
9
2023
entrez:
21
9
2023
Statut:
aheadofprint
Résumé
Osteoporosis in candidates for liver transplantation (LT) is often underdiagnosed despite the important consequences of morbidity. We included 376 patients with cirrhosis evaluated for LT with available computed tomography (CT) scans. Prevalent vertebral fractures (VFs) were identified on CT reconstructions, and bone density was assessed by measuring CT attenuation of the L1 vertebra (L1-CT). We identified 139 VFs in 55 patients (14.6%). Logistic regression models showed that low L1-CT was the only independent determinant of VF. In patients with cirrhosis evaluated for LT, CT scans identified persons with severe osteoporosis without additional costs.
Identifiants
pubmed: 37734343
doi: 10.14309/ajg.0000000000002507
pii: 00000434-990000000-00873
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 by The American College of Gastroenterology.
Références
Loria I, Albanese C, Giusto M, et al. Bone disorders in patients with chronic liver disease awaiting liver transplantation. Transplant Proc 2010;42(4):1191–3.
Krol CG, Dekkers OM, Kroon HM, et al. No association between BMD and prevalent vertebral fractures in liver transplant recipients at time of screening before transplantation. J Clin Endocrinol Metab 2014;99(10):3677–85.
Alcalde Vargas A, Pascasio Acevedo JM, Gutiérrez Domingo I, et al. Prevalence and characteristics of bone disease in cirrhotic patients under evaluation for liver transplantation. Transplant Proc 2012;44(6):1496–8.
Jang S, Graffy PM, Ziemlewicz TJ, et al. Opportunistic osteoporosis screening at routine abdominal and thoracic CT: Normative L1 trabecular attenuation values in more than 20000 adults. Radiology 2019;291(2):360–7.
Pickhardt PJ, Pooler BD, Lauder T, et al. Opportunistic screening for osteoporosis using abdominal computed tomography scans obtained for other indications. Ann Intern Med 2013;158(8):588–95.
Carberry GA, Pooler BD, Binkley N, et al. Unreported vertebral body compression fractures at abdominal multidetector CT. Radiology 2013;268(1):120–6.
Lindsay R, Silverman SL, Cooper C, et al. Risk of new vertebral fracture in the year following a fracture. JAMA 2001;285(3):320–3.
Guañabens N, Monegal A, Muxi A, et al. Patients with cirrhosis and ascites have false values of bone density: Implications for the diagnosis of osteoporosis. Osteoporos Int 2012;23(4):1481–7.
Dagan N, Elnekave E, Barda N, et al. Automated opportunistic osteoporotic fracture risk assessment using computed tomography scans to aid in FRAX underutilization. Nat Med 2020;26(1):77–82.
Pickhardt PJ, Graffy PM, Zea R, et al. Automated abdominal CT imaging biomarkers for opportunistic prediction of future major osteoporotic fractures in asymptomatic adults. Radiology 2020;297(1):64–72.
Löffler MT, Jacob A, Scharr A, et al. Automatic opportunistic osteoporosis screening in routine CT: Improved prediction of patients with prevalent vertebral fractures compared to DXA. Eur Radiol 2021;31(8):6069–77.
Bliuc D, Nguyen ND, Milch VE, et al. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 2009;301(5):513–21.
Khosla S, Shane E. A crisis in the treatment of osteoporosis. J Bone Miner Res 2016;31(8):1485–7.
Guichelaar MMJ, Kendall R, Malinchoc M, et al. Bone mineral density before and after OLT: Long-term follow-up and predictive factors. Liver Transpl 2006;12(9):1390–402.
Leidig-Bruckner G, Hosch S, Dodidou P, et al. Frequency and predictors of osteoporotic fractures after cardiac or liver transplantation: A follow-up study. Lancet 2001;357(9253):342–7.