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

Grant number: 14/22572-9
Support Opportunities:Scholarships in Brazil - Doctorate
Effective date (Start): March 01, 2016
Effective date (End): February 28, 2019
Field of knowledge:Health Sciences - Nutrition - Dietetics
Principal Investigator:Fernando Gomes Romeiro
Grantee:Lívia Alves Amaral Santos
Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil


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.

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Scientific publications (5)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
SANTOS, LIVIA A. A.; LIMA, TALLES B.; DO VAL IETSUGU, MARJORIE; DE CARVALHO NUNES, HELIO R.; QI, XINGSHUN; ROMEIRO, FERNANDO G.. Anthropometric measures associated with sarcopenia in outpatients with liver cirrhosis. NUTRITION & DIETETICS, v. 76, n. 5, p. 613-619, . (17/25592-9, 16/07117-9, 14/22572-9)
LIMA, TALLES BAZEIA; AMARAL SANTOS, LIVIA ALVES; DE CARVALHO NUNES, HELIO RUBENS; SILVA, GIOVANNI FARIA; CARAMORI, CARLOS ANTONIO; QI, XINGSHUN; ROMEIRO, FERNANDO GOMES. Safety and efficacy of risedronate for patients with esophageal varices and liver cirrhosis: a non-randomized clinical trial. SCIENTIFIC REPORTS, v. 9, . (14/22572-9, 16/07117-9)
AMARAL SANTOS, LIVIA ALVES; ROMEIRO, FERNANDO GOMES. Diagnosis and Management of Cirrhosis-Related Osteoporosis. BIOMED RESEARCH INTERNATIONAL, . (14/22572-9, 16/07117-9)
ROMEIRO, FERNANDO GOMES; IETSUGU, MARJORIE DO VAL; FRANZONI, LETICIA DE CAMPOS; AUGUSTI, LAIS; ALVAREZ, MATHEUS; AMARAL SANTOS, LIVIA ALVES; LIMA, TALLES BAZEI; KOGA, KATIA HIROMOTO; MORIGUCHI, SONIA MARTA; CARAMORI, CARLOS ANTONIO; et al. Which of the branched-chain amino acids increases cerebral blood flow in hepatic encephalopathy? A double-blind randomized trial. NEUROIMAGE-CLINICAL, v. 19, p. 302-310, . (14/22572-9, 16/07117-9, 13/15121-8, 13/11761-2)
AMARAL SANTOS, LIVIA ALVES; LIMA, TALLES BAZEIA; QI, XINGSHUN; RUPP DE PAIVA, SERGIO ALBERTO; ROMEIRO, FERNANDO GOMES. Refining dual-energy x-ray absorptiometry data to predict mortality among cirrhotic outpatients: A retrospective study. NUTRITION, v. 85, . (17/25592-9, 14/22572-9)
Academic Publications
(References retrieved automatically from State of São Paulo Research Institutions)
SANTOS, Lívia Alves Amaral. Response to treatment of osteoporosis and osteopenia in patients with liver cirrhosis. 2019. Doctoral Thesis - Universidade Estadual Paulista (Unesp). Faculdade de Medicina. Botucatu Botucatu.

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