Bone Abstracts

Introduction: Liver transplant candidates have bone and mineral metabolism disorders that may influence the development of fractures after liver transplantation (LT).

Objective: To analyze the levels of 25-hydroxyvitamin D (25-OH-D) in patient candidates for LT and the factors associated with vitamin D deficiency.

Methods: Between January 2010 and May 2012, 116 liver transplant candidates (85 male and 31 female patients) were included in the study. In all patients, we analyzed the clinical and laboratory characteristics (including serum 25-OH-D and PTH values), densitometry of the lumbar spine and femur (DXA) and spinal X-rays in lateral projection.

Results: In liver transplant candidates 25-OH-D mean levels were 14.1+10.3 ng/ml. 25-OH-D values were <10 ng/ml in 48%, <20 ng/ml in 81.9% and <30 in 93% of patients. Nevertheless only 9% of patients were supplemented with calcium and/or vitamin D. 25-OH-D values were related with the severity of the liver disease. Thus, child A patients showed higher values of 25-OH-D than child B and C patients (A: 18.5+12; B: 12.65+8.9; C: 9.36+5.2 ng/ml; P<0.001). 25-OH-D values were inferior to 10 ng/ml in 25% of child A, 59 of child B and 68% of child C patients (P<0.001). Moreover, patients with vitamin D deficiency (25-OH-D <10 ng/ml) showed lower values of lumbar Z-score (<10 ng/ml: −1.35+1.5 vs >10 ng/ml: −0.6+1.5; P<0.05), femoral neck Z-score (<10 ng/ml: −0.5+1.2 vs >10 ng/ml: −0.1+1; P<0.05) and total femur Z-score (<10 ng/ml: −0.7+1.2 vs >10 ng/ml: −0.2+1.1; P<0.05).

Conclusions: Vitamin D deficiency is frequent among liver transplant candidates. However, calcium and/or vitamin D supplementation is uncommon. Vitamins D deficiency was most frequent in the most severe liver disease patients. Moreover, patients with vitamin D deficiency had low bone mass.