Direct‑acting antiviral treatment decreases serum undercarboxylated osteocalcin in male patients with chronic hepatitis C

Ichikawa,Tatsuki; Yamashima,Mio; Yamamichi,Shinobu; Koike,Makiko; Nakano,Yusuke; Honda,Tetsurou; Yajima,Hiroyuki; Miyazaki,Osamu; Kuribayashi,Yasutaka; Ikeda,Tomonari; Okamura,Takuma; Nakao,Kazuhiko

doi:10.3892/br.2022.1567

Direct‑acting antiviral treatment decreases serum undercarboxylated osteocalcin in male patients with chronic hepatitis C

Authors:
- Tatsuki Ichikawa
- Mio Yamashima
- Shinobu Yamamichi
- Makiko Koike
- Yusuke Nakano
- Tetsurou Honda
- Hiroyuki Yajima
- Osamu Miyazaki
- Yasutaka Kuribayashi
- Tomonari Ikeda
- Takuma Okamura
- Kazuhiko Nakao
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Affiliations: Department of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki 850‑8555, Japan, Innovation and Translational Research Center, Nagasaki Harbor Medical Center, Nagasaki 850‑8555, Japan, Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852‑8501, Japan
Published online on: September 1, 2022 https://doi.org/10.3892/br.2022.1567
Article Number: 84

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Abstract

Hepatic osteodystrophy (HOD) is a common complication of chronic liver disease, including viral hepatitis. Hepatitis C virus (HCV) infection is associated with an increased risk of osteoporosis and bone mineral density (BMD) loss. Direct‑acting antiviral (DAA) treatment is used to treat HCV infections; however, its effects on bone metabolism have not been reported. We compared the clinical data and bone metabolic markers at the start of DAA treatment and 1 year later in 78 patients. There were 41 female and 37 male patients. HCV was successfully treated with DAA in all patients. Bone metabolic markers included undercarboxylated osteocalcin (ucOC), 25(OH) vitamin D (VD), total type I procollagen N‑propeptide (P1NP), tartrate‑resistant acid phosphatase 5b (TRACP‑5b), and BMD. BMD was measured in the lumbar spine (mean, L2‑L4) and femoral neck using dual‑energy X‑ray absorptiometry. ucOC in males decreased at 1 year after treatment initiation but not in females. In males, ucOC changes were related to alterations in proteins induced by vitamin K absence‑II (PIVKA‑II), hemoglobin A1c, and TRACP‑5b, which contributed to P1NP and lumbar BMD at the start of DAA. Changes in ucOC among women contributed to the changes in grip strength and TRACP‑5b levels. DAA treatment improved ucOC, a useful bone metabolic marker, in HCV‑infected male patients. Changes in ucOC contributed to changes in PIVKA‑II that likely ameliorated the vitamin K deficiency. DAA treatment has been reported to improve various extrahepatic disorders and abnormal bone metabolism, especially in HOD.

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