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Growth hormone/insulin-like growth factor-1 axis, calciotropic hormones and bone mineral density in young patients with chronic viral hepatitis
open access
Abstract
Introduction: Chronic liver disease caused by HBV and HCV infections, due to its great prevalence and serious medical consequences, is at the present time a significant clinical problem. An impaired liver function can provoke severe disturbances in calcium and phosphorus homeostasis, and consequently in the bone metabolism resulting in hepatic osteodystrophy. The aim of this study was to determine whether there are significant differences in bone mineral density (BMD) and/or circadian levels of hormones connected with bone metabolism and bone turnover markers in patients with chronic viral hepatitis.
Material and methods: Circadian levels (AUC, area under the curve) of GH, IGF-I, IGFBP-3, osteocalcin (BGLAP), C-terminal telopeptide of type I collagen (ICTP), PTH, 25(OH)D, total calcium and total phosporus were measured in the blood of members of the study group (n = 80). BMD was assessed using the dual-energy X-ray absorptiometry method of the L2-L4 lumbar spine. Data was compared to that of healthy individuals (n = 40).
Results: BMD (1.05 g/cm3 vs. 1.20 g/cm3), total calcium concentration (2.20 mmol/L vs. 2.45 mmol/L), total phosphorus concentration (1.06 mmol/L vs. 1.33 mmol/L), IGF-I (AUC 3,982.32 ng/mL vs. 5,167.61 ng/mL), IGFBP-3 (AUC 725.09 ng/L vs. 944.35 ng/L), 25(OH)D (AUC 356.35 ng/mL vs. 767.53 ng/mL) and BGLAP (AUC 161.39 ng/L vs. 298 ng/L) were lower in the study group. GH (AUC 88.3 ng/mL vs. 48.04 ng/mL), iPTH (AUC 1,201.94 pg/mL vs. 711.73 pg/mL) and ICTP (AUC 104.30 μg/L vs. 54.49 μg/L) were higher in patients with hepatitis. Positive correlations were noted between bone mineral density and IGF-I, IGFBP-3, and BGLAP levels.
Conclusions: Chronic viral hepatitis causes a decrease in bone mineral density. Impaired liver function disrupts homeostasis of the calcium– vitamin D–parathyroid hormone axis and provokes secondary hyperparathyroidism. Chronic viral hepatitis induces a decrease in the synthesis of IGF-I and IGFBP-3 and an increase in GH secretion. Hepatic osteodystrophy is probably caused by both changes in calciotropic hormones as well as in the somatotropin hormone axis.
Abstract
Introduction: Chronic liver disease caused by HBV and HCV infections, due to its great prevalence and serious medical consequences, is at the present time a significant clinical problem. An impaired liver function can provoke severe disturbances in calcium and phosphorus homeostasis, and consequently in the bone metabolism resulting in hepatic osteodystrophy. The aim of this study was to determine whether there are significant differences in bone mineral density (BMD) and/or circadian levels of hormones connected with bone metabolism and bone turnover markers in patients with chronic viral hepatitis.
Material and methods: Circadian levels (AUC, area under the curve) of GH, IGF-I, IGFBP-3, osteocalcin (BGLAP), C-terminal telopeptide of type I collagen (ICTP), PTH, 25(OH)D, total calcium and total phosporus were measured in the blood of members of the study group (n = 80). BMD was assessed using the dual-energy X-ray absorptiometry method of the L2-L4 lumbar spine. Data was compared to that of healthy individuals (n = 40).
Results: BMD (1.05 g/cm3 vs. 1.20 g/cm3), total calcium concentration (2.20 mmol/L vs. 2.45 mmol/L), total phosphorus concentration (1.06 mmol/L vs. 1.33 mmol/L), IGF-I (AUC 3,982.32 ng/mL vs. 5,167.61 ng/mL), IGFBP-3 (AUC 725.09 ng/L vs. 944.35 ng/L), 25(OH)D (AUC 356.35 ng/mL vs. 767.53 ng/mL) and BGLAP (AUC 161.39 ng/L vs. 298 ng/L) were lower in the study group. GH (AUC 88.3 ng/mL vs. 48.04 ng/mL), iPTH (AUC 1,201.94 pg/mL vs. 711.73 pg/mL) and ICTP (AUC 104.30 μg/L vs. 54.49 μg/L) were higher in patients with hepatitis. Positive correlations were noted between bone mineral density and IGF-I, IGFBP-3, and BGLAP levels.
Conclusions: Chronic viral hepatitis causes a decrease in bone mineral density. Impaired liver function disrupts homeostasis of the calcium– vitamin D–parathyroid hormone axis and provokes secondary hyperparathyroidism. Chronic viral hepatitis induces a decrease in the synthesis of IGF-I and IGFBP-3 and an increase in GH secretion. Hepatic osteodystrophy is probably caused by both changes in calciotropic hormones as well as in the somatotropin hormone axis.
Keywords
GH; IGF-I; PTH; osteocalcin; vitamin D; BMD; chronic hepatitis; bone; liver
About this articleTitle
Growth hormone/insulin-like growth factor-1 axis, calciotropic hormones and bone mineral density in young patients with chronic viral hepatitis
Journal
Issue
Article type
Original paper
Pages
22-29
Published online
2015-03-02
Page views
2041
Article views/downloads
2456
DOI
10.5603/EP.2015.0005
Pubmed
Bibliographic record
Endokrynol Pol 2015;66(1):22-29.
Keywords
GH
IGF-I
PTH
osteocalcin
vitamin D
BMD
chronic hepatitis
bone
liver
Authors
Bogdan Marek
Dariusz Kajdaniuk
Danuta Niedziołka
Halina Borgiel-Marek
Mariusz Nowak
Lucyna Siemińska
Zofia Ostrowska
Joanna Głogowska-Szeląg
Tomasz Piecha
Łukasz Otręba
Bernard Holona
Aleksandra Kazimierczak
Joanna Wierzbicka-Chmiel
Beata Kos-Kudła
