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Bone disease in patients with primary sclerosing cholangitis
Paul Angulo1, Garfield A Grandison, Derek G Fong
1Division of Digestive Diseases and Nutrition, University of Kentucky Medical Center, Lexington, Kentucky 40536, USA. paul.angulo@uky.edu
Gastroenterology
|October 20, 2010
Summary
Osteoporosis is common in primary sclerosing cholangitis (PSC) patients. Identifying older age, low BMI, and long inflammatory bowel disease duration helps target bone density screening and treatment.
Area of Science:
- Hepatology and Gastroenterology
- Bone Metabolism and Disease
Background:
- Osteopenic bone disease is prevalent in chronic liver disease but understudied in primary sclerosing cholangitis (PSC).
- This study addresses the prevalence, progression, and predictors of bone disease in PSC patients across all disease stages.
Purpose of the Study:
- To investigate the prevalence and progression rate of osteopenic bone disease in primary sclerosing cholangitis (PSC).
- To identify independent predictors of bone disease in patients with PSC.
Main Methods:
- Bone mineral density (BMD) was measured annually for 10 years in 237 PSC patients.
- Measurements included the lumbar spine, hip, and total body bone density.
Main Results:
- Osteoporosis (T-score < -2.5) was found in 15% of PSC patients, a 23.8-fold increased frequency compared to the general population.
- Independent predictors of osteoporosis included age ≥ 54 years, body mass index ≤ 24 kg/m², and inflammatory bowel disease (IBD) duration ≥ 19 years.
- Patients with all three risk factors had a 75% osteoporosis rate, versus 3.1% without these factors. PSC patients lost 1% bone mass annually, linked to IBD duration.
Conclusions:
- Osteoporosis is a frequent complication in primary sclerosing cholangitis (PSC) patients.
- Age, low BMI, and long IBD duration are key factors for identifying PSC patients needing bone density assessment and treatment.
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