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ORIGINAL ARTICLE
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Investigation of the influential factors for hepatic osteodystrophy in chronic liver disease: A case–control survey among the patients attending a tertiary care hospital in a rural region of Northern India


1 Department of Medicine, Bhagat Phool Singh Government Medical College for Women Sonipat, Haryana, India
2 Department of Transfusion Medicine, Bhagat Phool Singh Government Medical College for Women, Sonipat, Haryana, India
3 Bhagat Phool Singh Government Medical College for Women, Sonipat, Haryana, India
4 Department of Psychiatry, Bhagat Phool Singh Government Medical College for Women, Sonipat, Haryana, India

Correspondence Address:
Sunny Garg,
Department of Psychiatry, Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonipat - 131 305, Haryana
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tcmj.tcmj_27_22

Objectives: Hepatic osteodystrophy (HOD) is a well-recognized complication of chronic liver diseases (CLD), but the influential factors associated with this complication were studied scarcely in a rural Indian population. The study aims to evaluate the prevalence of HOD and variables that might influence it among cases diagnosed with CLD. Materials and Methods: It is a cross-sectional observational design survey that was performed in a hospital among the two-hundred cases and controls with a 1:1 ratio who were age (>18 years) and gender matched in a period between April and October 2021. They were subjected to etiological workup, hematological and biochemical investigations, and Vitamin D levels. Then, dual-energy X-ray absorptiometry was used to measure the bone mineral densitometry (BMD) for whole-body, lumbar spine (LS), and hip. HOD was diagnosed according to the WHO criteria. Then, the Chi-square test and conditional logistic regression analysis were used to investigate the influential factors of HOD in CLD patients. Results: The whole-body, LS-spine, and hip BMDs in CLD cases were found to be significantly lower as compared to controls. When the participants among both groups were stratified by age and gender, a significant difference in LS-spine and hip BMD was observed in elderly patients (>60 years), and in both the male and female patients. HOD was found in 70% of CLD patients. After multivariate analysis in CLD patients, we identified that being a male patient (odds ratio [OR] = 3.03), older age (OR = 3.54), duration of illness for more than 5 years (OR = 3.89), decompensated liver dysfunction with Child–Turcotte–Pugh-B and C grading (OR = 8.28), and low level of Vitamin D (OR = 18.45) were the risk factors for HOD. Conclusion: This study concludes that severity of illness and lower level of Vitamin D were the main influential factors for HOD. Supplementation of Vitamin D and calcium in the patients can abate the risk of fractures in our rural communities.


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    -  Yadav E
    -  Kaur RD
    -  Sasan A
    -  Garg S
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