title: Decrease in bone mass in women after liver transplantation: associated factors.
abstract: BACKGROUND
  In the future, an increasing number of female liver transplant recipients will reach the climacteric with osteoporosis as a common complication. We evaluated the factors associated with decreased bone mass among women after liver transplantation.
  
  
  METHODS
  A prospective, cross-sectional study of 23 outpatient transplant recipients followed from February 2009 to March 2010 included women of age ≥35 years after liver transplantations ≥1 year prior. We recorded patient histories, liver enzyme levels, as well as bone mineral densities measured at the lumbar spine and femur. Statistical analysis used Fisher's exact test, simple odds ratio (OR), and Spearman's rank correlation coefficient.
  
  
  RESULTS
  The mean patient age was 52.5 ± 11 years with 30.4% premenopausal, and 69.6% perimenopausal or postmenopausal. Approximately 21% showed osteoporosis and 35%, a low bone mass. Postmenopausal women: OR 69.0 (95% CI 2.89-1647.18; P<.0001), aged ≥49 years: OR 13.33 (95% CI 1.78-100.15; P=.0123) and receiving a transplant after 44 years of age: OR 49.50 (95% CI 3.84-638.43; P<.0001) were associated with a lower bone mass. Having undergone transplantation for more than 5.8 years lowered the risk of bone mass change: OR 0.11 (95% CI 0.02-0.78; P=.0361). Clinical and laboratory variables, including corticosteroid use, were not associated with decreased bone mass.
  
  
  CONCLUSIONS
  Understanding the prevalence and factors associated with osteoporosis among female liver transplant recipients is important to enhance the strategies to diagnose and treat these women, seeking to improve their quality of life.
authors.affiliation: Department of Gynecology, State University of Campinas, Campinas, Brazil. luiz.baccaro@gmail.com
authors.forename: L F
authors.initials: LF
authors.lastname: Baccaro
authors.forename: I F S F
authors.initials: IF
authors.lastname: Boin
authors.forename: A O
authors.initials: AO
authors.lastname: Pedro
authors.forename: L
authors.initials: L
authors.lastname: Costa-Paiva
authors.forename: A L G
authors.initials: AL
authors.lastname: Leal
authors.forename: C D
authors.initials: CD
authors.lastname: Ramos
authors.forename: A M
authors.initials: AM
authors.lastname: Pinto-Neto
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000367:Age Factors; D000368:Aged; D015519:Bone Density; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D005269:Femur / Q000473:pathology*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000473:pathology*; D008875:Middle Aged; D016017:Odds Ratio; D010024:Osteoporosis / Q000209:etiology* / Q000473:pathology; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome