Desmistificando o Diagnóstico e Manejo da Osteodistrofia Hepática na Colestase e Outras Hepatopatias
uma revisão
DOI:
https://doi.org/10.51723/ccs.v29i03.214Keywords:
Cirrhosis, Osteoporosis, OsteopeniaAbstract
Hepatic osteodystrophy (OH) involves the presence of osteoporosis, osteopenia, or, less frequently, osteomalacia that affects liver disease and this term is very controversial. There is a lack of consensus in the literature on what is considered liver disease in this context. Chronic liver disease is associated with increased bone loss. In Brazil, the first bone densitometry is indicated at more advanced ages and cirrhosis is not considered as a risk factor for osteopenia and osteoporosis. We have to worry about low bone mineral density not only in chronic liver disease but especially in cirrhosis, especially if cholestasis is the cause. It is necessary to estimate the bone mass and to act before a possible liver transplant, since this would bring even more deleterious consequences to the bone mass due to the incorporated use of corticosteroids during the immunosupression. The purpose of this article is to demystify the conduction of the investigation and treatment of OH in cholestatic and non - cholestatic liver diseases, through literature review.
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References
1. Bihari, C., Lal, D., Thakur, M., Sukriti, S., Mathur, D., Patil, A. G at al. Suboptimal Level of Bone-Forming Cells in Advanced Cirrhosis are Associated with Hepatic Osteodystrophy. Hepatology communications. 2018, 2(9), 1095-1110. doi:10.1002/hep4.1234
2. Bandgar, T., Lila, A., Shivane, V., Shah N. Chronic liver disease and skeletal health (hepatic osteodystrophy). Journal of Postgraduate Medicine, 2012. 58(2):
103-6.
3. Fan, J.; Wang, Q.; Sun, L. Association between primary biliary cholangitis and
Osteoporosis: meta-analysis. Clinical Rheumatology, 2017, 26 nov. V. 36, n. 11, 2565–2571.
4. Ruiz-Gaspà, S., Martinez-Ferrer, A, Enjuanes, A., Peris, P., Mertinez de Osaba, M J, Alvarez, L. et al. High bilirubin reduces cell survival and differentiation of primary human osteoblasts. Is this effect applicable to the serum of chronic cholestatic patients? Bone. 2010.47:S214– S215.
5. Marchioni Beery, R. M., Vaziri, H., & Forouhar, F., Primary Biliary Cirrhosis And
Primary Sclerosing Cholangitis: A Review Featuring A Women’s Health Perspective.
Journal Of Clinical And Translational Hepatology. 2014. 2(4), 266–84.
6. Goel, V. & Kar, P. Hepatic Osteodystrophy. Tropical Gastroenterology; 2010. 31(2):82– 86.
7. Auletta, M., Nuzzo, V., Esposito, A., Antoniello, S., Fonderico, F. , Lupoli, G. et al. Osteoporosis in men: a study in patients affected by Chronic non-advanced liver disease. Clinical Cases in Mineral and Bone Metabolism, 2(1), 25–28, 2005.
8. Gatta, A., Verardo, A., Di Pascoli, M., Giannini, S., & Bolognesi, M. Hepatic osteodystrophy. Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases, 2014. 11(3), 185-91.
9. Guañabens, N. & parés, A., Liver and bone. Archives of Biochemistry and Biophysics, 2010. 503(1), 84–94.
10. Guañabens N, Parés A, Ros I, Caballería L, Pons F, Vidal S et al.. Severity of cholestasis and Advanced histological stage but not menopausal status are the major risk factors for osteoporosis in primary biliary cirrhosis. Journal of Hepatology, 2005. 42(4), 573–577.
11. Portaria No 224, de 26 de março de 2014 – Protocolo Clínico e Diretrizes Terapêuticas (PCDT) da Osteoporose.
12. Guañabens, N., Osteoporosis. Medicina clinica, 1994.102(9), 346–53.
13. Bredella MA, Torriani M, Ghomi RH, Thomas BJ, Brick DJ, Gerweck AV et al.
Determinants of bone mineral density in obese premenopausal women. Bone, 2011. 4812 (4).
14. Souza, M.P.G. Diagnóstico e tratamento da osteoporose. Rev Bras Ortop.; 2010. 45(3): 220-9.
15. López-Larramona, G., Lucendo, A. J., González-Castillo, S., & Tenias, J. M.
Hepatic osteodystrophy: An important matter for consideration in chronic liver disease. World J Hepatol, 2011, 3(312), 300–307.
16. Gasser, R.W., Cholestasis and metabolic bone disease – a clinical review. Wiener Medizinische Wochenschrift, 2008. 158(19–20), 553–557.
17. Kowdley KV, Emond MJ, Sadowski JA, Kaplan MM. Plasma vitamin K1 level is decreased in primary biliary cirrhosis. The American journal of gastroenterology, 1997. vol 92 (11), 2059-61.
18. Dumortier, J., Scoazec, J-Y., Valette, P-J. Randomized pilot trial of vitamin K2 for bone loss in patients with primary biliary cirrhosis – Letter to the editor. J Hepatol, 2001.vol 35 (13), 543-545.
19. Goral V, Simsek M, Mete N) Hepatic osteodystrophy and liver cirrhosis. World J Gastroenterol. 2010. 16(13):1639–1643.
20. Brandão, CMA, Camargos, BM, Zerbini, CA, Plapler, PG, Carvalho, LM, Albergaria, MBH et al Posições oficiais 2008 da Sociedade Brasileira de Densitometria Clínica (SBDens). Arq Bras Endocrinol Metab. 2009; 53/1.
21. Leslie, William D, Bernstein, NC, Leboffb, MS. AGA technical review on osteoporosis in hepatic disorders. Gastroenterology . 2003; Vol125 , 3, 941-966.
22. EASL Clinical Practice Guidelines on nutrition in chronic liver disease. J Hepatol (2018), https://doi.org/10.1016/j.jhep.2018.06.024.
23. Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY et al.
European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis Int 2013; 24:23–57.
24. Guanabens N, Pares A, Monegal A, Peris P, Pons F, Alvarez L, et al. Etidronate versus fluoride for treatment of osteopenia in primary biliary cirrhosis: preliminary results after 2 years. Gastroenterology 1997; 113: 219–224.
25. Guanabens N, Pares A, Ros I, Alvarez L, Pons F, Caballeria L, et al. Alendronate is more effective than etidronate for increasing bone mass in osteopenic patients with primary biliary cirrhosis. Am J Gastroenterol 2003; 98: 2268-2274.
26. Lindor KD, Jorgensen RA, Tiegs RD, Khosla S, Dickson ER. Etidronate for osteoporosis in primary biliary cirrhosis: a randomized trial. J Hepatol. 2000; 33: 878–882.
27. Wolfhagen FH, van Buuren HR, den Ouden JW, Hop WC, van Leeuwen JP, Schalm SW, et al. Cyclical etidronate in the prevention of bone loss in corticosteroid-treated primary biliary cirrhosis. A prospective, controlled pilot study. J Hepatol. 1997; 26: 325–330.
28.Guanabens N, Monegal A, Cerda D, Muxi A, Gifre L, Peris P, et al. Randomized trial comparing monthly ibandronate and weekly alendronate for osteoporosis in patients with primary biliary cirrhosis. Hepatology. 2013;58: 2070–2078.
29. Zein CO, Jorgensen RA, Clarke B, Wenger DE, Keach JC, Angulo P, et al. Alendronate improves bone mineral density in primary biliary cirrhosis: a randomized placebo-controlled trial. Hepatology. 2005; 42: 762–771.
2. Bandgar, T., Lila, A., Shivane, V., Shah N. Chronic liver disease and skeletal health (hepatic osteodystrophy). Journal of Postgraduate Medicine, 2012. 58(2):
103-6.
3. Fan, J.; Wang, Q.; Sun, L. Association between primary biliary cholangitis and
Osteoporosis: meta-analysis. Clinical Rheumatology, 2017, 26 nov. V. 36, n. 11, 2565–2571.
4. Ruiz-Gaspà, S., Martinez-Ferrer, A, Enjuanes, A., Peris, P., Mertinez de Osaba, M J, Alvarez, L. et al. High bilirubin reduces cell survival and differentiation of primary human osteoblasts. Is this effect applicable to the serum of chronic cholestatic patients? Bone. 2010.47:S214– S215.
5. Marchioni Beery, R. M., Vaziri, H., & Forouhar, F., Primary Biliary Cirrhosis And
Primary Sclerosing Cholangitis: A Review Featuring A Women’s Health Perspective.
Journal Of Clinical And Translational Hepatology. 2014. 2(4), 266–84.
6. Goel, V. & Kar, P. Hepatic Osteodystrophy. Tropical Gastroenterology; 2010. 31(2):82– 86.
7. Auletta, M., Nuzzo, V., Esposito, A., Antoniello, S., Fonderico, F. , Lupoli, G. et al. Osteoporosis in men: a study in patients affected by Chronic non-advanced liver disease. Clinical Cases in Mineral and Bone Metabolism, 2(1), 25–28, 2005.
8. Gatta, A., Verardo, A., Di Pascoli, M., Giannini, S., & Bolognesi, M. Hepatic osteodystrophy. Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases, 2014. 11(3), 185-91.
9. Guañabens, N. & parés, A., Liver and bone. Archives of Biochemistry and Biophysics, 2010. 503(1), 84–94.
10. Guañabens N, Parés A, Ros I, Caballería L, Pons F, Vidal S et al.. Severity of cholestasis and Advanced histological stage but not menopausal status are the major risk factors for osteoporosis in primary biliary cirrhosis. Journal of Hepatology, 2005. 42(4), 573–577.
11. Portaria No 224, de 26 de março de 2014 – Protocolo Clínico e Diretrizes Terapêuticas (PCDT) da Osteoporose.
12. Guañabens, N., Osteoporosis. Medicina clinica, 1994.102(9), 346–53.
13. Bredella MA, Torriani M, Ghomi RH, Thomas BJ, Brick DJ, Gerweck AV et al.
Determinants of bone mineral density in obese premenopausal women. Bone, 2011. 4812 (4).
14. Souza, M.P.G. Diagnóstico e tratamento da osteoporose. Rev Bras Ortop.; 2010. 45(3): 220-9.
15. López-Larramona, G., Lucendo, A. J., González-Castillo, S., & Tenias, J. M.
Hepatic osteodystrophy: An important matter for consideration in chronic liver disease. World J Hepatol, 2011, 3(312), 300–307.
16. Gasser, R.W., Cholestasis and metabolic bone disease – a clinical review. Wiener Medizinische Wochenschrift, 2008. 158(19–20), 553–557.
17. Kowdley KV, Emond MJ, Sadowski JA, Kaplan MM. Plasma vitamin K1 level is decreased in primary biliary cirrhosis. The American journal of gastroenterology, 1997. vol 92 (11), 2059-61.
18. Dumortier, J., Scoazec, J-Y., Valette, P-J. Randomized pilot trial of vitamin K2 for bone loss in patients with primary biliary cirrhosis – Letter to the editor. J Hepatol, 2001.vol 35 (13), 543-545.
19. Goral V, Simsek M, Mete N) Hepatic osteodystrophy and liver cirrhosis. World J Gastroenterol. 2010. 16(13):1639–1643.
20. Brandão, CMA, Camargos, BM, Zerbini, CA, Plapler, PG, Carvalho, LM, Albergaria, MBH et al Posições oficiais 2008 da Sociedade Brasileira de Densitometria Clínica (SBDens). Arq Bras Endocrinol Metab. 2009; 53/1.
21. Leslie, William D, Bernstein, NC, Leboffb, MS. AGA technical review on osteoporosis in hepatic disorders. Gastroenterology . 2003; Vol125 , 3, 941-966.
22. EASL Clinical Practice Guidelines on nutrition in chronic liver disease. J Hepatol (2018), https://doi.org/10.1016/j.jhep.2018.06.024.
23. Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY et al.
European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis Int 2013; 24:23–57.
24. Guanabens N, Pares A, Monegal A, Peris P, Pons F, Alvarez L, et al. Etidronate versus fluoride for treatment of osteopenia in primary biliary cirrhosis: preliminary results after 2 years. Gastroenterology 1997; 113: 219–224.
25. Guanabens N, Pares A, Ros I, Alvarez L, Pons F, Caballeria L, et al. Alendronate is more effective than etidronate for increasing bone mass in osteopenic patients with primary biliary cirrhosis. Am J Gastroenterol 2003; 98: 2268-2274.
26. Lindor KD, Jorgensen RA, Tiegs RD, Khosla S, Dickson ER. Etidronate for osteoporosis in primary biliary cirrhosis: a randomized trial. J Hepatol. 2000; 33: 878–882.
27. Wolfhagen FH, van Buuren HR, den Ouden JW, Hop WC, van Leeuwen JP, Schalm SW, et al. Cyclical etidronate in the prevention of bone loss in corticosteroid-treated primary biliary cirrhosis. A prospective, controlled pilot study. J Hepatol. 1997; 26: 325–330.
28.Guanabens N, Monegal A, Cerda D, Muxi A, Gifre L, Peris P, et al. Randomized trial comparing monthly ibandronate and weekly alendronate for osteoporosis in patients with primary biliary cirrhosis. Hepatology. 2013;58: 2070–2078.
29. Zein CO, Jorgensen RA, Clarke B, Wenger DE, Keach JC, Angulo P, et al. Alendronate improves bone mineral density in primary biliary cirrhosis: a randomized placebo-controlled trial. Hepatology. 2005; 42: 762–771.
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Published
2019-04-29
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1.
Mendes LSC. Desmistificando o Diagnóstico e Manejo da Osteodistrofia Hepática na Colestase e Outras Hepatopatias: uma revisão. Com. Ciências Saúde [Internet]. 2019 Apr. 29 [cited 2024 Jul. 3];29(03). Available from: https://revistaccs.escs.edu.br/index.php/comunicacaoemcienciasdasaude/article/view/214
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