Evaluation of bone resorption in male patients with bilharzial periportal hepatic fibrosis

ABSTRACT

To evaluate bone resorption and bone mineral metabolism in male patients suffering from bilharzial periportal hepatic fibrosis by assessment of liver function tests and factors that regulate bone resorption and formation and correlate these factors to bone mineral density assessing bone mineral metabolism. This study was carried out on 50 male patients suffering from bilharzial periportal hepatic fibrosis; their mean age was 38.6 +/- 8.14. Also 40 age matched healthy males were included in this study as a control group. Both patients and control groups were subjected to the following investigations [parathyroid hormone [PTH], testosterone, vitamin D3 [1-25 hydroxycholecalciferol], serum calcium and phosphorus, total alkaline phosphatase and liver function tests including [SGOT, SGPT, total protein, albumin, total and direct bilirubin] in addition to dual energy X-ray absorbtiometry [DEXA] and abdominal ultrasonography. patients suffering from bilharzial periportal hepatic fibrosis showed highly significant reduction of serum testosterone and bone mineral density [BMD] in comparison to control group [p<0.001] and the testosterone is highly correlated with BMD [p<0.001] parathyroid hormone, vitamin D3, serum calcium and phosphorus showed non significant difference between both studied groups [p>0.05] and not correlated with BMD [p>0.05]. However, liver function tests were significantly higher in patients than control group [p<0.01]. Our results demonstrate that the liver is an important organ responsible for bone integrity and any chronic liver disease like bilharzial periportal liver fibrosis can directly affect the bone and causing osteoporosis which indicated by diminished BMD and this osteoporosis was accompanied with gonadal dysfunction indicated by reduced testosterone so it is called [Andropausal osteoporosis]