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Bone mineral density and trabecular bone score in treatment-naïve patients with non-cirrhotic hepatitis C virus infection

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Abstract

Summary

We studied 112 treatment-naïve chronic HCV patients without cirrhosis, and we found that, especially HCV+ postmenopausal women, they had lower TBS and BMD values than healthy controls. This suggests that HCV infection is an independent risk factor for osteoporosis, and therefore, screening for osteoporosis in postmenopausal HCV+ women should be considered.

Purpose

To know whether patients in earlier stages of chronic HCV infection are at increased risk of developing low bone mass and bone microarchitectural changes and whether there is an association between bone metabolism and the severity of the liver disease.

Methods

We studied 112 treatment-naïve chronic HCV outpatients and 233 healthy age- and sex-matched controls. Bone mineral density (BMD) and trabecular bone score (TBS) were assessed by DXA. Serum 25(OH)D, PTH, P1NP, and CTX were determined by electrochemiluminescence.

Results

TBS values were significantly lower in HCV patients than in controls, both considering the population as a whole (1.337 ± 0.119 vs. 1.377 ± 0.122; p < 0.005) and after stratifying by sex (1.347 ± 0.12 vs. 1.381 ± 0.13 in men and 1.314 ± 0.10 vs. 1.369 ± 0.11 in women). The difference remained significant (p < 0.0001 in all cases) after adjusting for confounders. BMD was also lower in HCV patients (lumbar spine, 0.935 ± 0.151 vs. 0.991 ± 0.143 g/cm2, p 0.001; femoral neck, 0.764 ± 0.123 vs. 0.818 ± 0.123 g/cm2, p 0.0001; total hip, 0.926 ± 0.148 vs. 0.963 ± 0.132 g/cm2, p 0.02), although, after adjustment, differences kept a clear trend towards statistical significance in women at the lumbar spine and femoral neck. However, in men and at the total hip in women, differences were no longer significant. We find no relationship between these parameters and the severity of the disease. No significant difference was observed in PTH and 25OHD status after adjustment. Finally, serum P1NP, but not CTX, was higher in HCV patients.

Conclusions

Our findings suggest that HCV infection is an independent risk factor for osteoporosis, especially among postmenopausal women. Therefore, the appropriateness of screening for osteoporosis in postmenopausal HCV-positive women should be considered.

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Funding

This study received funding by grants from the Instituto de Salud Carlos III (PI18/00762 and PIE15/00079), Ministerio de Economía y Competitividad, Spain, that included FEDER funds from the EU.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Hospital Universitario Marqués de Valdecilla-IDIVAL, Universidad de Cantabria, Santander, Spain

    José M. Olmos-Martínez, Emilio Fábrega & Javier Crespo

  2. Bone Metabolic Unit, Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla-IDIVAL, Universidad de Cantabria, Avda. Valdecilla s/n, 39008, Santander, Spain

    José L. Hernández, José M. Olmos & Jesús González-Macías

Authors
  1. José M. Olmos-Martínez
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  2. José L. Hernández
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  3. Emilio Fábrega
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  4. José M. Olmos
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  5. Javier Crespo
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  6. Jesús González-Macías
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Corresponding author

Correspondence to José L. Hernández.

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The study was approved by the local Ethics Committee (Comité Ético de Investigación Clínica de Cantabria-IDIVAL, internal code: 2016.003), and all the subjects gave written informed consent.

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Olmos-Martínez, J.M., Hernández, J.L., Fábrega, E. et al. Bone mineral density and trabecular bone score in treatment-naïve patients with non-cirrhotic hepatitis C virus infection. Arch Osteoporos 15, 72 (2020). https://doi.org/10.1007/s11657-020-00752-1

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