中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 5
May  2022
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2022  >  38(5): 1041-1047

Risk factors for osteopenia/osteoporosis and the diagnostic value of CT value in patients with chronic hepatitis B

DOI: 10.3969/j.issn.1001-5256.2022.05.013
  • a.

    Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, Kunming 650000, China

  • b.

    Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming 650000, China

Research funding:

National Natural Science Foundation of China (81660102);

National Natural Science Foundation of China (81360072)

More Information
  • Corresponding author: TANG Yingmei, tangyingmei_med@kmmu.edu.cn(ORCID: 0000-0002-0731-4198)
  • Received Date: 2021-09-29
  • Accepted Date: 2021-11-01
  • Published Date: 2022-05-20
    Abstract
  •   Objective  To investigate the value of the CT values of thoracolumbar vertebrae measured by abdominal CT in the diagnosis of osteopenia/osteoporosis in patients with chronic hepatitis B, as well as the risk factors for osteopenia/osteoporosis in such patients.  Methods  A retrospective analysis was performed for 112 patients with chronic hepatitis B in the Second Affiliated Hospital of Kunming Medical University from January 2019 to December 2020. All patients underwent abdominal CT, and some patients underwent dual-energy X-ray absorptiometry (DXA). The CT values of T12 vertebral body to L3 vertebral body were measured, and the value of CT value of each vertebral body in the diagnosis of osteopenia/osteoporosis was analyzed in comparison with T-score of L1-L4 vertebral bodies measured by DXA. With the CT values of vertebral bodies as the diagnostic criteria, the patients with chronic hepatitis B enrolled were divided into osteopenia/osteoporosis group with 55 patients and normal bone mass group with 57 patients. Clinical features and biochemical parameters were compared between the two groups to analyze the risk factors for osteopenia/osteoporosis in patients with chronic hepatitis B. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test, the Fisher's exact test, and the Bonferroni correction test were used for comparison of categorical data between groups. A Pearson correlation analysis was performed to investigate correlation, and a binary logistic regression analysis was used for multivariate analysis. The receiver operating characteristic (ROC) curve was used to investigate the value of CT values of T12-L3 vertebral bodies in the diagnosis of osteopenia/osteoporosis in patients with chronic hepatitis B. The Kappa test was used check consistency.  Results  A total of 46 patients who completed abdominal CT and DXA during the same time of hospitalization were analyzed, and their CT values of T12-L3 vertebral bodies were significantly positively correlated with the T-score values of L1-L4 vertebral bodies in DXA (rT12=0.694, rL1=0.661, rL2=0.781, rL3=0.685, all P < 0.001). The ROC curve analysis showed that the CT value of L2 vertebral body had the largest area under the ROC curve of 0.863 and showed a good accuracy in the diagnosis of osteopenia/osteoporosis, which was consistent with the results of DXA (K=0.648, P < 0.001). The clinical features and biochemical parameters of 112 patients with chronic hepatitis B were analyzed, and it was suggested that old age (odds ratio [OR]=1.108, 95% confidence interval [CI]: 1.026-1.196, P=0.009) and sarcopenia (OR=2.788, 95% CI: 1.009-7.707, P=0.048) were the risk factors for osteopenia/osteoporosis.  Conclusion  The patients with chronic hepatitis B often need regular abdominal CT to evaluate the progression of liver disease, and it is of high clinical significance to identify the presence or absence of osteopenia/osteoporosis and sarcopenia by measuring the CT value of L2 vertebral body and skeletal muscle area of L3 vertebrae plane, thereby giving timely intervention and improving patients' prognosis and quality of life.

     

    • FullText(HTML)
  • loading
    • References(24)
  • [1]
    World Health Organization. Global Hepatitis Report, 2017[OR]. WHO 2017: Geneva. http://www.who.int/hepatitis/publications/global-hepatitis-report2017/en/.
    [2]
    LUXON BA. Bone disorders in chronic liver diseases[J]. Curr Gastroenterol Rep, 2011, 13(1): 40-48. DOI: 10.1007/s11894-010-0166-4.
    [3]
    QIU ML, XIE Y, WANG XH, et al. Practice guideline for patients with osteoporosis[J]. Chin J Intern Med, 2020, 5(12): 953-959. DOI: 10.3760/cma.j.cn112138-20200904-00792.

    邱敏丽, 谢雅, 王晓红, 等. 骨质疏松症患者实践指南[J]. 中华内科学杂志, 2020, 5(12): 953-959. DOI: 10.3760/cma.j.cn112138-20200904-00792.
    [4]
    Chinese Society of Infectious Diseases, Chinese Medical Association; Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B (version 2019)[J]. Chin J Hepatol, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.

    中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35(12): 2648-2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.
    [5]
    HAYASHI M, ABE K, FUJITA M, et al. Association between sarcopenia and osteoporosis in chronic liver disease[J]. Hepatol Res, 2018, 48(11): 893-904. DOI: 10.1111/hepr.13192.
    [6]
    SCHREIBER JJ, ANDERSON PA, ROSAS HG, et al. Hounsfield units for assessing bone mineral density and strength: a tool for osteoporosis management[J]. J Bone Joint Surg Am, 2011, 93(11): 1057-1063. DOI: 10.2106/JBJS.J.00160.
    [7]
    NISHIKAWA H, SHIRAKI M, HIRAMATSU A, et al. Japan Society of Hepatology guidelines for sarcopenia in liver disease (1st edition): Recommendation from the working group for creation of sarcopenia assessment criteria[J]. Hepatol Res, 2016, 46(10): 951-963. DOI: 10.1111/hepr.12774.
    [8]
    WANG YF, SUN MX, XUE H, et al. Understanding the China Blue Paper on Obesity Prevention and Control and policy implications and recommendations for obesity prevention and control in China[J]. Chin J Rrev Med, 2019, 53(9): 875-884. DOI: 10.3760/cma.j.issn.0253-9624.2019.09.003.

    王友发, 孙明晓, 薛宏, 等. 《中国肥胖预防和控制蓝皮书》解读及中国肥胖预防控制措施建议[J]. 中华预防医学杂志, 2019, 53(9): 875-884. DOI: 10.3760/cma.j.issn.0253-9624.2019.09.003.
    [9]
    BYRNE DD, NEWCOMB CW, CARBONARI DM, et al. Risk of hip fracture associated with untreated and treated chronic hepatitis B virus infection[J]. J Hepatol, 2014, 61(2): 210-218. DOI: 10.1016/j.jhep.2014.04.001.
    [10]
    REID IR. Targeting sclerostin in postmenopausal osteoporosis: Focus on romosozumab and blosozumab[J]. BioDrugs, 2017, 31(4): 289-297. DOI: 10.1007/s40259-017-0229-2.
    [11]
    FORESTA C, SCHIPILLITI M, CIARLEGLIO FA, et al. Male hypogonadism in cirrhosis and after liver transplantation[J]. J Endocrinol Invest, 2008, 31(5): 470-478. DOI: 10.1007/BF03346393.
    [12]
    ZHU LJ, KE JT, LI M, et al. Studies related to the clearance of fibroblast growth factor 23 in patients with chronic renal failure by different modes of blood purification[J]. Chin J Integ Trad Western Nephrol, 2014, 15(6): 514-517. https://www.cnki.com.cn/Article/CJFDTOTAL-JXSB201406019.htm

    朱丽娟, 柯剑婷, 李宓, 等. 不同血液净化模式对慢性肾衰竭患者成纤维细胞生长因子23清除的相关研究[J]. 中国中西医结合肾病杂志, 2014, 15(6): 514-517. https://www.cnki.com.cn/Article/CJFDTOTAL-JXSB201406019.htm
    [13]
    ZHANG ZL, WEI Z. Advances in clinical studies of adefovir-induced renal tubular damage and osteochondrosis[J]. Chin J Intern Med, 2018, 57(12): 935-937. DOI: 10.3760/cma.j.issn.0578-1426.2018.12.013.

    章振林, 魏哲. 阿德福韦酯引起肾小管损害和骨软化临床研究进展[J]. 中华内科杂志, 2018, 57(12): 935-937. DOI: 10.3760/cma.j.issn.0578-1426.2018.12.013.
    [14]
    SMITH AD. Screening of bone density at CT: An overlooked opportunity[J]. Radiology, 2019, 291(2): 368-369. DOI: 10.1148/radiol.2019190434.
    [15]
    BAO J, ZOU D, LI WS. Research progress on lumbar CT attenuation value in assessing bone mineral density of patients with lumbar degenerative diseases[J]. Chin J Spine and Spinal Core, 2020, 30(8): 745-750. DOI: 10.3969/j.issn.1004-406X.2020.08.12.

    包洁, 邹达, 李危石. 椎体CT值评估腰椎退变患者骨密度的研究进展[J]. 中国脊柱脊髓杂志, 2020, 30(8): 745-750. DOI: 10.3969/j.issn.1004-406X.2020.08.12.
    [16]
    LEE S, CHUNG CK, OH SH, et al. Correlation between bone mineral density measured by dual-energy X-Ray absorptiometry and hounsfield units measured by diagnostic CT in lumbar spine[J]. J Korean Neurosurg Soc, 2013, 54(5): 384-389. DOI: 10.3340/jkns.2013.54.5.384.
    [17]
    HAO RR, WANG H, WANG HY, et al. Analysis of risk factors for senile sarcopenia and its relationship with NAFLD[J]. J Clin Exp Med, 2020, 19(15): 1588-1591. DOI: 10.3969/j.issn.1671-4695.2020.15.006.

    郝瑞瑞, 王欢, 王海燕, 等. 老年肌少症的危险因素分析及与NAFLD的关系研究[J]. 临床和实验医学杂志, 2020, 19(15): 1588-1591. DOI: 10.3969/j.issn.1671-4695.2020.15.006.
    [18]
    CHEN LR, YANG ZY. Research progress of intervention therapy for sarcopenia and understanding of traditional Chinese medicine[J]. Chin J Gerontol, 2021, 41(15): 3389-3392. DOI: 10.3969/j.issn.1005-9202.2021.15.063.

    陈丽如, 杨子艳. 肌少症的干预治疗研究进展及中医学认识[J]. 中国老年学杂志, 2021, 41(15): 3389-3392. DOI: 10.3969/j.issn.1005-9202.2021.15.063.
    [19]
    HOU JC, ZHANG YM. Progress of skeletal muscle mass evaluation, diagnosis and treatment of sarcopenia in patients with liver disease[J]. Chin J Hepatobiliary Surg, 2020, 26(11): 873-877. DOI: 10.3760/cma.j.cn113884-20200304-00112.

    侯建存, 张雅敏. 肝病患者肌肉减少症骨骼肌测量及诊治研究进展[J]. 中华肝胆外科杂志, 2020, 26(11): 873-877. DOI: 10.3760/cma.j.cn113884-20200304-00112.
    [20]
    CAREY EJ, LAI JC, SONNENDAY C, et al. A north american expert opinion statement on sarcopenia in liver transplantation[J]. Hepatology, 2019, 70(5): 1816-1829. DOI: 10.1002/hep.30828.
    [21]
    GOLSE N, BUCUR PO, CIACIO O, et al. A new definition of sarcopenia in patients with cirrhosis undergoing liver transplantation[J]. Liver Transpl, 2017, 23(2): 143-154. DOI: 10.1002/lt.24671.
    [22]
    CHEN JC, ZHU GT, LIU HW, et al. Common pathogenesis of "sarco-osteopenia"[J]. Chin J Osteoporosis Bone Miner Res, 2020, 13(1): 95-102. DOI: 10.3969/j.issn.1674-2591.2020.01.015.

    陈锦成, 朱国涛, 刘洪文, 等. "肌少-骨质疏松症"的共同发病机制[J]. 中华骨质疏松和骨矿盐疾病杂志, 2020, 13(1): 95-102. DOI: 10.3969/j.issn.1674-2591.2020.01.015.
    [23]
    FU SW. Clinical study of bone metabolic and biochemical indexes and osteoporosis in patients with liver cirrhosis or liver cancer[J]. Chin J Osteoporos, 2013, 19(11): 1177-1179. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZS201311015.htm

    付士武. 肝硬化、肝癌患者骨代谢生化指标与骨质疏松的临床研究[J]. 中国骨质疏松杂志, 2013, 19(11): 1177-1179. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZS201311015.htm
    [24]
    CHEN CH, LIN CL, KAO CH. Association between chronic hepatitis B virus infection and risk of osteoporosis: A nationwide population-based study[J]. Medicine (Baltimore), 2015, 94(50): e2276. DOI: 10.1097/MD.0000000000002276.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(4)  / Tables(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (420) PDF downloads(44) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return