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Association Between Chronic Hepatitis C Virus Infection and Bone Mineral Density

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Abstract

Whether chronic hepatitis C virus (HCV) infection is a risk factor for the development of bone disease has long been controversial. For this reason, chronic HCV-infected participants (n = 69) were recruited into a prospective cohort study and underwent dual-energy X-ray absorptiometry for determination of bone mineral density (BMD). Fibrosis staging was evaluated according to the noninvasive index FIB-4. T scores at the femoral neck and lumbar spine were used as the primary outcome variables to assess the association between degree of liver disease and BMD. The study cohort was 41 % male with a mean age of 53.6 years. The mean BMD, Z score, and T score values of lumbar spine in chronic hepatitis C (CHC) patients were significantly lower than those in healthy controls (p < 0.001). The rate of osteoporosis for CHC patients aged 45–54 years was significantly higher than that of the control group (p = 0.011). Bone alkaline phosphatase and C-terminal cross-linking telopeptide of type I collagen levels were also significantly higher in CHC patients with reduced BMD. Patients with more advanced liver fibrosis had significantly lower BMD. In conclusion, reduced BMD is common in this population of chronic HCV-infected patients and associated with liver disease severity. This extrahepatic manifestation is probably secondary to increased bone turnover in osteodystrophy pathogenesis.

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Acknowledgments

We thank Dr. Daniel Steve Villarreal for English-language editing and Ms. Yu-Ting Hsu for help in picture editing. We also thank the patients who participated in this study. This study was supported in part by a grant from the Foundation for Medical Research of Tri-Service General Hospital (TSGH-C99-167).

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Authors and Affiliations

  1. Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC

    Jung-Chun Lin, Tsai-Yuan Hsieh, Chia-Chun Wu, Peng-Jen Chen, Wei-Kuo Chang & Heng-Cheng Chu

  2. Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, 325, Sec. 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan, ROC

    Jung-Chun Lin, Tsai-Yuan Hsieh, Peng-Jen Chen, Wei-Kuo Chang & Heng-Cheng Chu

  3. Department of Orthopaedic, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC

    Chia-Chun Wu

  4. Institute of Statistics, National Chiao Tung University, Hsinchu, Taiwan, ROC

    Tung-Hung Chueh

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  1. Jung-Chun Lin
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Correspondence to Heng-Cheng Chu.

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The authors have stated that they have no conflict of interest.

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Lin, JC., Hsieh, TY., Wu, CC. et al. Association Between Chronic Hepatitis C Virus Infection and Bone Mineral Density. Calcif Tissue Int 91, 423–429 (2012). https://doi.org/10.1007/s00223-012-9653-y

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  • DOI: https://doi.org/10.1007/s00223-012-9653-y

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