Diagnosis and Management of Cirrhosis-Related Osteoporosis

Figure 1

Factors that can be involved in cirrhosis-related osteoporosis by modulating the activity of osteoblastic and osteoclastic cells. The factors most related to osteoblastic activity are illustrated in the left column. The factors related to both osteoblastic and osteoclastic activity are displayed in the middle column. The factors most related to osteoclastic activity are shown in the right column. OPG = osteoprotegerin; RANKL = receptor activator of nuclear factor kβ; IGF-1 = insulin-like growth factor 1. Although most factors are related to osteoblastic activity, malnutrition and alcohol abuse have a broad effect on bone loss because they can be involved in other risk factors displayed above, such as leptin levels and vitamin deficiencies.