The RANKL/OPG system and bone mineral density in patients with chronic liver disease

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• 作者：Alexander R. Moschen ; Arthur Kaser ; Sylvia Stadlmann ; Gunda Millonig ; Susanne Kaser ; Petra Mü ; hllechner ; Andrzej Habior ; Ivo Graziadei ; Wolfgang Vogel and Herbert Tilg
• 刊名：Journal of Hepatology
• 出版年：2005
• 出版时间：December 2005
• 年：2005
• 卷：43
• 期：6
• 页码：973-983
• 全文大小：973 K

文摘

Background/Aims

Osteopenia and osteoporosis are common complications of chronic liver disease (CLD). Receptor activator of nuclear factor κB ligand (RANKL) and osteoprotegerin (OPG) regulate osteoclastogenesis and bone remodelling, and are involved in several inflammatory diseases. This study investigated the activation state of the RANKL/OPG system and its association with bone loss in CLD.

Methods

Serum levels of OPG and sRANKL were determined in 193 patients with CLD and 56 age- and gender-matched healthy controls. Cellular sources of OPG and RANKL were determined immunohistochemically. Dual-energy x-ray absorptiometry was performed to determine bone mineral density (BMD) of lumbar spine and femoral neck.

Results

sRANKL serum levels were significantly elevated in non-cirrhotic, but not cirrhotic patients compared to healthy controls. OPG serum levels were elevated 1.6-fold in non-cirrhotic and 2.8-fold in cirrhotic CLD patients. RANKL⁺ cells were mainly confined to portal fields, while OPG was broadly expressed. In the cirrhotic subgroup (87 patients) we observed a significantly higher OPG/sRANKL ratio in patients with osteopenia or osteoporosis of the lumbar spine and femoral neck region (T-score <−1) compared to those with normal BMD (T-score−1).

Conclusions

CLD is associated with alterations in RANKL/OPG serum levels, which could modulate bone loss in CLD.