Bone changes in patients with liver cirrhosis treated for osteoporosis and osteopenia

• Grant number: 14/22572-9
• Support type: Scholarships in Brazil - Doctorate
• Effective date (Start): March 01, 2016
• Effective date (End): February 28, 2019
• Field of knowledge: Health Sciences - Nutrition - Dietetics
• Principal Investigator: Fernando Gomes Romeiro
• Grantee: Lívia Alves Amaral Santos
• Home Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Introduction: Patients with liver cirrhosis have bone loss generated by various mechanisms, such as low intake of nutrients and lack of physical activity. At the same time, the bone treatment is often avoided in this population, particularly in advanced cirrhosis, due to the presence of esophageal varices. Objectives: To evaluate whether patients with cirrhosis and osteoporosis would be able to recover their bone mineral density by drug treatment with risedronate associated with nutritional supplementation (calcium and vitamin D), and if individuals with osteopenia would be able to recover their bone mineral density by nutritional supplementation. Methods: The evaluation of bone mass will be done by DEXA (dual-energy X-Ray Absorptiometry), the nutritional assessment by anthropometric measures, hand grip and bioelectrical impedance analysis, and the evaluation of physical capacity by the walking test. Biochemical tests associated with the degree of liver dysfunction and bone loss will also be performed. All tests will be done at the beginning and the end of the study, and endoscopy exams will be done periodically to assess the impact on esophageal varices . Statistical analysis: comparisons between the same individuals at two time points will be done through the paired t test. The expected results are to register by the first-time the ability of cirrhotic patients to increase their bone mass, showing data on safety of these treatments. Additionally, this project will search for data linking the bone health to the muscle mass and the functional capacity of these individuals.

Scientific publications

(4)

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

LIMA, TALLES BAZEIA; AMARAL SANTOS, LIVIA ALVES; DE CARVALHO NUNES, HELIO RUBENS; SILVA, GIOVANNI FARIA; CARAMORI, CARLOS ANTONIO; QI, XINGSHUN; ROMEIRO, FERNANDO GOMES. Safety and efficacy of risedronate for patients with esophageal varices and liver cirrhosis: a non-randomized clinical trial. SCIENTIFIC REPORTS, v. 9, DEC 12 2019. Web of Science Citations: 0.

SANTOS, LIVIA A. A.; LIMA, TALLES B.; DO VAL IETSUGU, MARJORIE; DE CARVALHO NUNES, HELIO R.; QI, XINGSHUN; ROMEIRO, FERNANDO G. Anthropometric measures associated with sarcopenia in outpatients with liver cirrhosis. NUTRITION & DIETETICS, v. 76, n. 5, p. 613-619, NOV 2019. Web of Science Citations: 2.

ROMEIRO, FERNANDO GOMES; IETSUGU, MARJORIE DO VAL; FRANZONI, LETICIA DE CAMPOS; AUGUSTI, LAIS; ALVAREZ, MATHEUS; AMARAL SANTOS, LIVIA ALVES; LIMA, TALLES BAZEI; KOGA, KATIA HIROMOTO; MORIGUCHI, SONIA MARTA; CARAMORI, CARLOS ANTONIO; SILVA, GIOVANNI FARI; GOMES GARCIA BETTING, LUIZ EDUARDO. Which of the branched-chain amino acids increases cerebral blood flow in hepatic encephalopathy? A double-blind randomized trial. NEUROIMAGE-CLINICAL, v. 19, p. 302-310, 2018. Web of Science Citations: 1.

AMARAL SANTOS, LIVIA ALVES; ROMEIRO, FERNANDO GOMES. Diagnosis and Management of Cirrhosis-Related Osteoporosis. BIOMED RESEARCH INTERNATIONAL, 2016. Web of Science Citations: 4.

Academic Publications

(References retrieved automatically from State of São Paulo Research Institutions)

SANTOS, Lívia Alves Amaral. Resposta ao tratamento da osteoporose e osteopenia em portadores de cirrose hepática. 2019. Doctoral Thesis - Universidade Estadual Paulista "Júlio de Mesquita Filho" Faculdade de Medicina..