Bone changes in patients with liver cirrhosis treated for osteoporosis and osteopenia

Abstract

Introduction: Patients with liver cirrhosis have bone loss generated by various mechanisms, such as low intake of nutrients and lack of physical activity. At the same time, the bone treatment is often avoided in this population, particularly in advanced cirrhosis, due to the presence of esophageal varices. Objectives: To evaluate whether patients with cirrhosis and osteoporosis would be able to recover their bone mineral density by drug treatment with risedronate associated with nutritional supplementation (calcium and vitamin D), and if individuals with osteopenia would be able to recover their bone mineral density by nutritional supplementation. Methods: The evaluation of bone mass will be done by DEXA (dual-energy X-Ray Absorptiometry), the nutritional assessment by anthropometric measures, hand grip and bioelectrical impedance analysis, and the evaluation of physical capacity by the walking test. Biochemical tests associated with the degree of liver dysfunction and bone loss will also be performed. All tests will be done at the beginning and the end of the study, and endoscopy exams will be done periodically to assess the impact on esophageal varices . Statistical analysis: comparisons between the same individuals at two time points will be done through the paired t test. The expected results are to register by the first-time the ability of cirrhotic patients to increase their bone mass, showing data on safety of these treatments. Additionally, this project will search for data linking the bone health to the muscle mass and the functional capacity of these individuals.