Abstract
Transiliac biopsies from 34 female patients with corticosteroid treated chronic active hepatitis have been examined to determine the contributions made by decreased bone formation and increased bone resorption to bone loss associated with this condition and to determine the structural basis of the bone loss. Mean wall thickness was significantly reduced when compared with control values (p less than 0.001) as was the bone formation rate at tissue (p less than 0.005) and basic multicellular unit (p less than 0.005) level. The osteoid maturation period and the bone formation period were significantly prolonged (p less than 0.02 and 0.05). The total resorption surfaces were significantly increased (p less than 0.02) but the mean interstitial bone thickness was normal. The mean trabecular plate thickness was significantly reduced (p less than 0.005). These findings indicate that decreased bone formation plays a major role in bone loss associated with corticosteroid treated chronic active hepatitis and that the structural basis of bone loss is trabecular thinning.
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Selected References
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- Addison G. M., Hales C. N., Woodhead J. S., O'Riordan J. L. Immunoradiometric assay of parathyroid hormone. J Endocrinol. 1971 Mar;49(3):521–530. doi: 10.1677/joe.0.0490521. [DOI] [PubMed] [Google Scholar]
- Adinoff A. D., Hollister J. R. Steroid-induced fractures and bone loss in patients with asthma. N Engl J Med. 1983 Aug 4;309(5):265–268. doi: 10.1056/NEJM198308043090502. [DOI] [PubMed] [Google Scholar]
- Bikle D. D., Genant H. K., Cann C., Recker R. R., Halloran B. P., Strewler G. J. Bone disease in alcohol abuse. Ann Intern Med. 1985 Jul;103(1):42–48. doi: 10.7326/0003-4819-103-1-42. [DOI] [PubMed] [Google Scholar]
- Cuthbert J. A., Pak C. Y., Zerwekh J. E., Glass K. D., Combes B. Bone disease in primary biliary cirrhosis: increased bone resorption and turnover in the absence of osteoporosis or osteomalacia. Hepatology. 1984 Jan-Feb;4(1):1–8. doi: 10.1002/hep.1840040101. [DOI] [PubMed] [Google Scholar]
- Dempster D. W., Arlot M. A., Meunier P. J. Mean wall thickness and formation periods of trabecular bone packets in corticosteroid-induced osteoporosis. Calcif Tissue Int. 1983 Jul;35(4-5):410–417. doi: 10.1007/BF02405069. [DOI] [PubMed] [Google Scholar]
- Gallagher J. C., Aaron J., Horsman A., Wilkinson R., Nordin B. E. Corticosteroid osteoporosis. Clin Endocrinol Metab. 1973 Jul;2(2):355–368. doi: 10.1016/s0300-595x(73)80048-9. [DOI] [PubMed] [Google Scholar]
- Hahn T. J. Corticosteroid-induced osteopenia. Arch Intern Med. 1978 May 15;138(Spec No):882–885. [PubMed] [Google Scholar]
- Hahn T. J., Halstead L. R., Teitelbaum S. L., Hahn B. H. Altered mineral metabolism in glucocorticoid-induced osteopenia. Effect of 25-hydroxyvitamin D administration. J Clin Invest. 1979 Aug;64(2):655–665. doi: 10.1172/JCI109506. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Herlong H. F., Recker R. R., Maddrey W. C. Bone disease in primary biliary cirrhosis: histologic features and response to 25-hydroxyvitamin D. Gastroenterology. 1982 Jul;83(1 Pt 1):103–108. [PubMed] [Google Scholar]
- Hodgson S. F., Dickson E. R., Wahner H. W., Johnson K. A., Mann K. G., Riggs B. L. Bone loss and reduced osteoblast function in primary biliary cirrhosis. Ann Intern Med. 1985 Dec;103(6 ):855–860. doi: 10.7326/0003-4819-103-6-855. [DOI] [PubMed] [Google Scholar]
- Kato Y., Epstein O., Dick R., Sherlock S. Radiological patterns of cortical bone modelling in women with chronic liver disease. Clin Radiol. 1982 May 3;33(3):313–317. doi: 10.1016/s0009-9260(82)80276-6. [DOI] [PubMed] [Google Scholar]
- Kleerekoper M., Villanueva A. R., Stanciu J., Rao D. S., Parfitt A. M. The role of three-dimensional trabecular microstructure in the pathogenesis of vertebral compression fractures. Calcif Tissue Int. 1985 Dec;37(6):594–597. doi: 10.1007/BF02554913. [DOI] [PubMed] [Google Scholar]
- Matloff D. S., Kaplan M. M., Neer R. M., Goldberg M. J., Bitman W., Wolfe H. J. Osteoporosis in primary biliary cirrhosis: effects of 25-hydroxyvitamin D3 treatment. Gastroenterology. 1982 Jul;83(1 Pt 1):97–102. [PubMed] [Google Scholar]
- Mobarhan S. A., Russell R. M., Recker R. R., Posner D. B., Iber F. L., Miller P. Metabolic bone disease in alcoholic cirrhosis: a comparison of the effect of vitamin D2, 25-hydroxyvitamin D, or supportive treatment. Hepatology. 1984 Mar-Apr;4(2):266–273. doi: 10.1002/hep.1840040216. [DOI] [PubMed] [Google Scholar]
- Parfitt A. M., Mathews C. H., Villanueva A. R., Kleerekoper M., Frame B., Rao D. S. Relationships between surface, volume, and thickness of iliac trabecular bone in aging and in osteoporosis. Implications for the microanatomic and cellular mechanisms of bone loss. J Clin Invest. 1983 Oct;72(4):1396–1409. doi: 10.1172/JCI111096. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Parfitt A. M., Pødenphant J., Villanueva A. R., Frame B. Metabolic bone disease with and without osteomalacia after intestinal bypass surgery: a bone histomorphometric study. Bone. 1985;6(4):211–220. doi: 10.1016/8756-3282(85)90003-1. [DOI] [PubMed] [Google Scholar]
- Payne R. B., Little A. J., Williams R. B., Milner J. R. Interpretation of serum calcium in patients with abnormal serum proteins. Br Med J. 1973 Dec 15;4(5893):643–646. doi: 10.1136/bmj.4.5893.643. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rickers H., Deding A., Christiansen C., Rødbro P. Mineral loss in cortical and trabecular bone during high-dose prednisone treatment. Calcif Tissue Int. 1984 May;36(3):269–273. doi: 10.1007/BF02405329. [DOI] [PubMed] [Google Scholar]
- Stellon A. J., Davies A., Compston J., Williams R. Bone loss in autoimmune chronic active hepatitis on maintenance corticosteroid therapy. Gastroenterology. 1985 Nov;89(5):1078–1083. doi: 10.1016/0016-5085(85)90212-4. [DOI] [PubMed] [Google Scholar]
- Stellon A. J., Davies A., Compston J., Williams R. Osteoporosis in chronic cholestatic liver disease. Q J Med. 1985 Nov;57(223):783–790. [PubMed] [Google Scholar]
- Stellon A. J., Webb A., Compston J., Williams R. Low bone turnover state in primary biliary cirrhosis. Hepatology. 1987 Jan-Feb;7(1):137–142. doi: 10.1002/hep.1840070127. [DOI] [PubMed] [Google Scholar]
- Vedi S., Compston J. E., Webb A., Tighe J. R. Histomorphometric analysis of bone biopsies from the iliac crest of normal British subjects. Metab Bone Dis Relat Res. 1982;4(4):231–236. doi: 10.1016/0221-8747(82)90032-7. [DOI] [PubMed] [Google Scholar]
- Vedi S., Tighe J. R., Compston J. E. Measurement of total resorption surface in iliac crest trabecular bone in man. Metab Bone Dis Relat Res. 1984;5(6):275–280. doi: 10.1016/0221-8747(84)90014-6. [DOI] [PubMed] [Google Scholar]
