The micro-structural analysis of lumbar vertebrae in alcoholic liver cirrhosis

Jadzic, J.; Cvetkovic, D.; Milovanovic, P.; Tomanovic, N.; Zivkovic, V.; Nikolic, S.; Djuric, M.; Djonic, D.

Affiliations

¹Laboratory for Anthropology and Skeletal Biology, Institute for Anatomy, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

²Institute of Forensic Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

³Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Abstract and keywords

Summary: Although vertebral fracture is more common among alcoholic liver cirrhosis patients when compared to general population, current data on three-dimensional micro-architecture are scarce. Our study showed significant trabecular deterioration in lumbar vertebrae obtained from alcoholic liver cirrhosis donors, suggesting that they should be advised to undergo early-stage screening for osteoporosis.

Purpose: Recent studies showed an increased incidence of vertebral fractures in alcoholic liver cirrhosis (ALC) patients, while data about vertebral micro-structure are still limited. The aim of this study was to compare trabecular and cortical micro-architecture of lumbar vertebrae between ALC patients and healthy age- and sex-matched controls.

Methods: Our study included lumbar vertebral samples of male cadaveric donors, divided into ALC (n = 20, age: 59 ± 6 years) and control group (n = 20, age: 59 ± 8 years). Following pathohistological verification of liver cirrhosis, trabecular and cortical bone micro-architecture was analyzed by micro-computed tomography (micro-CT).

Results: Micro-CT evaluation of the trabecular bone in lumbar vertebrae showed a significant decrease in bone volume fraction, trabecular thickness, trabecular number, and connectivity (p < 0.01). In contrast to trabecular deterioration, prominent alteration in cortical parameters was not observed in lumbar vertebrae of ALC patients (p > 0.05).

Conclusions: Our data indicate that susceptibility to non-traumatic fractures in ALC patients could be explained by alterations in trabecular bone micro-architecture. Thus, we genuinely recommend osteological screening of the lumbar spine for all ALC patients in order to evaluate individual fracture risk.

Keywords: Alcoholic liver cirrhosis; Micro-CT; Osteoporosis; Trabecular micro-architecture; Vertebral fractures

Links

DOI: 10.1007/s00198-020-05509-7

PubMed: 32577771

WoS: 000542509400001

History

Received: 2020-03-02

Accepted: 2020-06-16

Online: 2020-06-24

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Cited By (1)

Year	Entry
2021	Jadzic J, Milovanovic P, Cvetkovic D, Ivovic M, Tomanovic N, Bracanovic M, Zivkovic V, Nikolic S, Djuric M, Djonic D. Mechano-structural alteration in proximal femora of individuals with alcoholic liver disease: implications for increased bone fragility. Bone. September 2021;150:116020.