Reduction of volumetric bone mineral density in postmenopausal women with HCV-correlated chronic liver disease: a peripheral quantitative computed tomogtraphy (pQCT) study

Background: The prevalence of osteoporosis in chronic liver disease (CLD) varies considerably among thestudies, depending on patient selection and diagnostic criteria. We aimed to measure bone turnover markersand volumetric bone mineral density (BMD) in a group of postmenopausal women with CLD using bothdual energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT), incomparison with age-matched healthy subjects.Methods: Thirty-five postmenopausal patients with HCV-correlated CLD and 35 healthy postmenopausalwomen, as controls, underwent a DXA scan at lumbar and femoral level and a pQCT measurement of thenondominant forearm. Serum concentrations of biochemical markers relevant to bone turnover werealso measured.Results: Patients showed no differences in DXA values either at lumbar or femoral level compared to controls.On the contrary, pQCT geometrical (cortical cross-sectional area) and volumetric (total and trabecular volumetricBMD) parameters were significantly reduced in the CLD women. Also the Strength–Strain Index (SSI),an estimate of diaphyseal bone resistance to bending and torsion, was significantly lower in patients than incontrols. Patients with CLD presented an unbalanced bone turnover, with increased bone resorption markers.Conclusions: The bone geometrical and volumetric parameters measured in our CLD postmenopausal women,by pQCT, show a reduced bone mineral quality and stiffness. Conversely, DXA-measurements seem unable toappreciate the bone alterations in these patients. This would encourage further studies to validate pQCT analysisas a diagnostic tool for a correct estimate of bone involvement in CLD.