Osteopatía en el paciente afecto de infección por virus C
- Ricardo Pelazas González
- Carlos Emilio González Reimers
- María Remedios Alemán Valls
- E. García-Valdecasas
- M.J. de La Vega Prieto
- M.A. Gómez Rodríguez
- J. López Prieto
- Francisco Santolaria Fernández
ISSN: 1132-8460
Año de publicación: 2009
Volumen: 18
Número: 1
Páginas: 15-19
Tipo: Artículo
Otras publicaciones en: Revista Española de Enfermedades Metabólicas Oseas
Objetivos de desarrollo sostenible
Resumen
Introduction Although it is known that alcoholic liver disease is associated with bone disease, there are few studies that analyze bone alterations in chronic hepatitis C virus (HCV) infection. Material and methods Twenty-eight consecutive patients affected by HCV infection admitted to the Internal Medicine Service of the Hospital Universitario de Canarias were included. Biochemical markers of bone turnover (cortisol, PTH, 1.25 dihydroxyvitamin D, IGF1, osteocalcin) were measured. Nutritional status was assessed by anthropometry, and fat mass, bone mineral density, and lean mass were all determined by densitometry (DEXA). These data were compared with those of a control group of similar age. Results Our patients had decreased body mass (BMD) values compared to the controls, especially intense among HIV co-infected individuals. We found significant differences between HIV infected and not infected patients in relation to right rib (T=2.26, p=0.037), lumbar spine (T=2.45, p=0.025) and pelvis (T=2.23, p=0.04). There was a significant relation between BMD in the right arm and brachial perimeter (p=0.019) and between lean mass at different levels and BMD (total lean mass at left arm r=0.69, at right arm r=0.71, thoracic spine r=0.79, lumbar spine r=0.53). We found a significant inverse relation between BMD and Knodell index (relation between BMD at right rib and Knodell, p=0.041, and BMD at lumbar spine and Knodell index, p=0.033). Conclusions In patients with chronic HCV infection, there is a reduction of bone mass, particularly in HIV co-infected patients. This reduction is related to a reduction of the lean mass but not to fat mass, and maintains a relationship with viral load and histological activity.