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The micro-structural analysis of lumbar vertebrae in alcoholic liver cirrhosis

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Abstract

Summary

Although vertebral fracture is more common among alcoholic liver cirrhosis patients when compared to general population, current data on three-dimensional micro-architecture are scarce. Our study showed significant trabecular deterioration in lumbar vertebrae obtained from alcoholic liver cirrhosis donors, suggesting that they should be advised to undergo early-stage screening for osteoporosis.

Purpose

Recent studies showed an increased incidence of vertebral fractures in alcoholic liver cirrhosis (ALC) patients, while data about vertebral micro-structure are still limited. The aim of this study was to compare trabecular and cortical micro-architecture of lumbar vertebrae between ALC patients and healthy age- and sex-matched controls.

Methods

Our study included lumbar vertebral samples of male cadaveric donors, divided into ALC (n = 20, age: 59 ± 6 years) and control group (n = 20, age: 59 ± 8 years). Following pathohistological verification of liver cirrhosis, trabecular and cortical bone micro-architecture was analyzed by micro-computed tomography (micro-CT).

Results

Micro-CT evaluation of the trabecular bone in lumbar vertebrae showed a significant decrease in bone volume fraction, trabecular thickness, trabecular number, and connectivity (p < 0.01). In contrast to trabecular deterioration, prominent alteration in cortical parameters was not observed in lumbar vertebrae of ALC patients (p > 0.05).

Conclusions

Our data indicate that susceptibility to non-traumatic fractures in ALC patients could be explained by alterations in trabecular bone micro-architecture. Thus, we genuinely recommend osteological screening of the lumbar spine for all ALC patients in order to evaluate individual fracture risk.

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Data availability

All data generated or analyzed during this study are included in this article [and its supplementary information files] and could be available from the corresponding author on request.

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Funding

This work was supported by the Ministry of Education and Science of the Republic of Serbia [grant number 45005].

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Authors and Affiliations

  1. Laboratory for Anthropology and Skeletal Biology, Institute for Anatomy, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    J. Jadzic, P. Milovanovic, M. Djuric & D. Djonic

  2. Institute of Forensic Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    D. Cvetkovic, V. Zivkovic & S. Nikolic

  3. Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    N. Tomanovic

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  1. J. Jadzic
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Correspondence to D. Djonic.

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All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amandments or comparable ethical standards. For this type of study, formal consent of study participant could not be provided.

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Jadzic, J., Cvetkovic, D., Milovanovic, P. et al. The micro-structural analysis of lumbar vertebrae in alcoholic liver cirrhosis. Osteoporos Int 31, 2209–2217 (2020). https://doi.org/10.1007/s00198-020-05509-7

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  • DOI: https://doi.org/10.1007/s00198-020-05509-7

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