title: Severity of cholestasis and advanced histological stage but not menopausal status are the major risk factors for osteoporosis in primary biliary cirrhosis.
abstract: BACKGROUND
  Since primary biliary cirrhosis (PBC) is usually diagnosed in postmenopausal women with minor cholestasis, it has been questioned whether PBC itself represents a further risk for osteoporosis.
  
  
  OBJECTIVE
  To assess the prevalence and risk factors for osteoporosis in an unselected series of women with PBC.
  
  
  METHODS
  142 women with PBC (age: 54.3+/-0.8 years) and an age-matched control group. Osteoporosis was established by densitometry (bone mineral density below -2.5 T-score). Age, duration and severity of PBC, body mass index, menopausal status, histological stage and markers of bone turnover were assessed.
  
  
  RESULTS
  Prevalence of osteoporosis was higher in PBC (32.4%) than in normal women (11. 1%) (RR: 3.83, 95%CI: 2.59-5.67, P<0.001). Osteoporosis was associated with older age, menopausal status, body mass index, longer PBC duration, advanced histological stage, high bilirubin and alkaline phosphatase, and low albumin and prothrombin index. Regression analysis identified older age, higher Mayo risk score, lower body mass index and advanced histological stage but not menopause as the independent risk factors for osteoporosis.
  
  
  CONCLUSIONS
  Osteoporosis is more prevalent in women with PBC than in the general population. Age and severity of the disease, but not menopausal status, are the main risk factors for osteoporosis in this liver disease.
authors.affiliation: Metabolic Bone Diseases Unit, Service of Rheumatology, Hospital Clínic, IDIBAPS, University of Barcelona, C/Villarroel 170, 08036-Barcelona, Spain. nguanabens@ub.edu
authors.forename: Núria
authors.initials: N
authors.lastname: Guañabens
authors.forename: Albert
authors.initials: A
authors.lastname: Parés
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Ros
authors.forename: Llorenç
authors.initials: L
authors.lastname: Caballería
authors.forename: Francesca
authors.initials: F
authors.lastname: Pons
authors.forename: Sergi
authors.initials: S
authors.lastname: Vidal
authors.forename: Ana
authors.initials: A
authors.lastname: Monegal
authors.forename: Pilar
authors.initials: P
authors.lastname: Peris
authors.forename: Juan
authors.initials: J
authors.lastname: Rodés
mesh_terms: D015415:Biomarkers; D015992:Body Mass Index; D015519:Bone Density; D002779:Cholestasis / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000453:epidemiology* / Q000473:pathology*; D008593:Menopause; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology* / Q000473:pathology*; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers