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Osteoporosis: still a typical complication of primary biliary cirrhosis?
E Solerio1, G Isaia, R Innarella
1Division of Gastroenterology and Hepatology, Gradenigo Hospital, C.so Regina Margherita 10, 10153 Turin, Italy.
Background:
Osteoporosis is a recognized complication of primary biliary cirrhosis but it has been suggested that its prevalence may overlap that observed among postmenopausal women.
Aim:
To evaluate prevalence and risk factors of osteoporosis in primary biliary cirrhosis.
Patients:
A total of 133 female patients (age 53+/-10 years, menopausal status 70%, histological stage I-II 61%, portal hypertension 28%, Mayo Risk Score 4.11+/-0.59) were enrolled.
Methods:
Dual X-ray absorptiometry of the lumbar spine.
Results:
Mean bone mineral density, T and Z score were 0.861+/-0.160 g/cm2, -1.87+/-1.45 and -0.78+/-2.63, respectively. At multivariate analysis, bone mineral density was inversely correlated with age (p<0.05). Osteoporosis was present in 39/92 (41%) postmenopausal and 8/41 (20%) premenopausal patients. In the premenopausal group, osteoporosis was significantly correlated with serum albumin (p<0.05) and Mayo Risk score (p<0.005). No significant correlation was present in the postmenopausal group.
Conclusions:
Despite the accepted wisdom that osteoporosis is a common complication of primary biliary cirrhosis, its frequency in post-menopausal patients overlaps that observed in the general population, but is much more frequent in premenopausal patients, where it appears to be related to severity of liver disease and cholestasis.
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