Bone loss in primary biliary cirrhosis: absence of association with severity of liver disease.
OBJECTIVE
The aim of the study was to measure the lumbar bone mineral density in women with primary biliary cirrhosis and to evaluate whether bone mineral density was related to the liver disease, hormonal status and corticosteroid use in these women.


METHODS
Bone mineral density of the lumbar spine (L2-L4) was assessed by dual emission X-ray absorptiometry in 40 women with primary biliary cirrhosis. Hormonal, bone and liver status were compared with bone mineral density and analyzed by nonparametric statistical tests.


RESULTS
Bone loss was evidenced in women with primary biliary cirrhosis compared with control age-matched women (Z-score: -0.9 SD), 32.5% had osteoporosis and 32.5% had osteopenia. The main risk factor of bone loss was the hormonal status: T-score was -1 SD in premenopausal women, -1.1 SD in postmenopausal women receiving an hormonal replacementtherapy and - 2.7SD in postmenopausal untreated women. There was no statistically significant relationship between bone mineral density and biological and histological liver characteristics.


CONCLUSIONS
Primary biliary cirrhosis-associated bone loss was significantly related to postmenopausal estrogen deficiency, and efficiently prevented by hormonal replacement therapy. Interestingly, the severity of primary biliary cirrhosis was not a determinant factor for bone loss in these women.
Le Gars
Laurence
L
Rheumatology Department, Hĵpital Saint-Antoine, Paris, France. laurence.legars@sat.ap-hop-paris.fr
Grandpierre
Caroline
C
Chazouillères
Olivier
O
Berenbaum
Francis
F
Poupon
Raoul
R
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D015519:Bone Density; D015914:Estrogen Replacement Therapy; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D008111:Liver Function Tests; D008159:Lumbar Vertebrae / Q000378:metabolism; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use
D005938:Glucocorticoids; D011241:Prednisone