INDEX osteoporosis with

TSCHOPP O, BOEHLER A, SPEICH R, WEDER W, SEIFERT B, RUSSI E W and SCHMID C (2002) OsteoporOsis before lung transplantation association with low body mass index, but not with imderlying disease. Am J Transplant. 2 (2) 167-72. 

Osteoporosis is also common in those on long-term corticosteroid therapy (for example patients with autoimmune hepatitis or coexisting inflammatory bowel disease). Patients with chronic liver disease may also have other risk factors for osteoporosis related to their disease state. These include vitamin D deficiency, excessive alcohol consumption, poor diet, physical inactivity and low body mass index. Oestrogen deficiency in the postmenopausal stage further increases the risk. 

Longer-term use is more problematic, given the probable increase (though < 2-fold) in fhe risk of breast cancer associated with extended use. Reasonable candidates are the small proportion of postmenopausal women with documented osteoporosis or osteopenia (decreased bone density) or those at increased risk for osteoporosis (personal or family history of nontraumatic fracture, ciurent smokers, or those with a body-mass index < 22) who do not have a personal or family history of breast cancer or other contraindications and who are willing to try this therapy. With more long-term... 

Susceptibility factors Inflammatory bowel disease is a susceptibility factor for abnormal bone metabolism, with a large amount of evidence of increased incidences of osteopenia and osteoporosis in adults. However, only a few studies of bone mineral density have been performed in children and adolescents with inflammatory bowel disease. Bone mineral density in the lumbar spine has been evaluated in 40 children and adolescents with inflammatory bowel disease, mean age 12 years, 26 with ulcerative colitis and 14 with Crohn s disease, in order to identify the associated susceptibility factors [15 ]. There was a low bone mineral density (Z-score worse than —2) in 25% of patients, with equal prevalences in Crohn s disease and ulcerative cohtis. Height for age, basal metabolic index, and cumulative glucocorticoid dose had independent effects, and these effects remained significant after adjustment for disease duration. 

A study of 224 Korean HFV-l infected patients on either ZDV based regimens or ABC based regimes found that low bone mineral density was independently associated with older age, lower body mass index, and ART >3 months [149 ]. Those on ABC for less than 1 year had a higher prevalence of osteoporosis than those treated for longer. Osteoporosis of the spine was more common than in the femur in the ABC regimen group. 

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