Grip strength is a strong indicator of osteoporosis in both women and men with chronic liver disease.

AIM: Osteoporosis (Op) and sarcopenia are common complications of chronic liver disease. We sought to identify clinical screening indicators for Op, and evaluated their relationship with bone and muscle.

METHOD: We retrospectively evaluated 495 patients (264 women) with chronic liver disease who underwent a bone mineral density evaluation at their first outpatient visit. Bone mineral density was measured in the lumbar spine (mean of L2-L4) and femoral neck using dual-energy X-ray absorptiometry. The relationship between Op and various clinical factors was examined.

RESULTS

Op was diagnosed in 156 patients (31.5%). Sex, age, steatotic liver disease, fibrosis-4 index, body mass index, and grip strength (GS) were associated with Op. In logistic multivariate analysis, Op was associated with older age (>68 years in women and >69 years in men), low body mass index (<20), and low GS (<18 kg in women and <28 kg in men). Factors associated with Op were analyzed in 254 patients whose body composition was evaluated. Op was associated with older age, low GS, and low skeletal muscle (<86 cm2) in women, and only low skeletal muscle (<116 cm2) in men. Combined Op and sarcopenia was observed in 19.6% of patients. Sarcopenia was associated with Op in both sexes. The number of patients with a low GS increased with age in both sexes. However, the number of patients with low bone mineral density increased with age in women, but not in men.

CONCLUSION

Low GS is an indicator of Op in both sexes. Overlooked Op in chronic liver disease should be screened using GS.