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Provedor de dados:  BJMBR
País:  Brazil
Título:  Longitudinal evaluation of hepatic osteodystrophy in children and adolescents with chronic cholestatic liver disease
Autores:  Taveira,A.T.A.
Pereira,F.A.
Fernandes,M.I.M.
Sawamura,R.
Nogueira-Barbosa,M.H.
Paula,F.J.A.
Data:  2010-11-01
Ano:  2010
Palavras-chave:  Hepatic osteodystrophy
Insulin-like growth factor-I
Osteoporosis
Bone mineral density
Bone remodeling
Resumo:  Bone mass loss is a major complication of chronic cholestatic liver disease (CCD). However, the long-term impact of CCD on bone mass acquisition is unknown. We longitudinally assessed bone mineral density (BMD) and factors involved in bone remodeling in 9 children and adolescents with CCD Child-Pugh A (5 boys/4 girls) and in 13 controls (6 boys/7 girls). The groups were evaluated twice, at baseline (T0) and after 3 years (T1), when osteocalcin, deoxypyridinoline, 25-hydroxyvitamin-D, parathyroid hormone, insulin-like growth factor-I (IGF-I), and BMD (L1-L4, proximal femur and total body) were determined. Serum levels of receptor activator for nuclear factor kB ligand (RANKL) and osteoprotegerin were measured only at T1. Lumbar spine BMD was reanalyzed twice: after adjustment for bone age and to compensate for the height factor. Volumetric density was also estimated mathematically in L2-L4. The BMD of L1-L4 was lower in the CCD group (Z-score at T0: control = -1.2 ± 0.8 vs CCD = -2.2 ± 1.4, P < 0.05; T1: control = -0.7 ± 0.8 vs CCD = -2.1 ± 1.1, P < 0.05). Osteocalcin and deoxypyridinoline were similar for the two groups. The CCD group presented lower IGF-I (Z-score at T1: control = 1.4 ± 2.8 vs CCD = -1.5 ± 1.0, P < 0.05) and RANKL (control = 0.465 ± 0.275 vs CCD = 0.195 ± 0.250 pM, P < 0.05) than control. Children with compensated CCD Child-Pugh A showed early impairment of bone acquisition, with the impact being more severe in an initial phase and then tapering in a slowly progressive way. Reduction in endocrine IGF-I has a crucial role in this process.
Tipo:  Info:eu-repo/semantics/article
Idioma:  Inglês
Identificador:  http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2010001100017
Editor:  Associação Brasileira de Divulgação Científica
Relação:  10.1590/S0100-879X2010007500118
Formato:  text/html
Fonte:  Brazilian Journal of Medical and Biological Research v.43 n.11 2010
Direitos:  info:eu-repo/semantics/openAccess
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