Effect of Nutrition and Body Composition on Bone Density After Liver Transplantation

We investigated the relationship between nutrition, body composition, and bone mineral density (BMD) in young adults after liver transplantation. Method: A cross-sectional study involving bone densitometry, anthropometry, and detailed food and lifestyle questionnaires. Results: Of 37 patients recruited, 26 were male. The mean age was 38.8 (±12.3) years, and the posttransplant period was 7.5 (±5.1) years (range 1.3-16.4). A significant proportion of patients (23 [62%]) were overweight (BMI 25-29.9) or obese (BMI ≥30). A total of 20 (54%) patients were osteopenic, and four (11%) had osteoporosis (lumbar spine or total body BMD). Lean mass showed a statistically significant correlation with lumbar spine and total body BMD in men and women, the most significant being bone mineral content, r = 0.66, P = .01. The correlation was stronger in females (r = 0.81, P < .01) than in males (r = 0.56, P < .01). The average daily intake of vitamin D, total protein, and phosphorus was greater than 100% of the American Dietary Reference recommendations, calcium was 90%, and magnesium 56%. There was no significant relationship between any nutritional parameter and BMD nor history of fractures, steroid use, or length of time from transplantation. Conclusion: Osteopenia determined by lumbar spine BMD underestimates poor BMD in our population of young adults after liver transplant. Maintaining muscle mass may be helpful in preserving BMD. The effect of a limited intake of magnesium needs further investigation.