title: Is liver transplantation associated with decreased bone mass in climacteric women?
abstract: OBJECTIVE
  To evaluate whether climacteric women undergoing liver transplantation had higher prevalence of decreased bone mass than those without any liver disease.
  
  
  METHODS
  A cross-sectional study with 48 women receiving follow-up care at a university hospital in Southeastern Brazil, from February 4th 2009 to January 5th 2011, was conducted. Of these women, 24 were 35 years or older and had undergone liver transplantation at least one year before study entry. The remaining 24 women had no liver disease and their ages and menstrual patterns were similar to those of transplanted patients. Laboratorial tests (follicle-stimulating hormone and estradiol) and bone density measurements of the lumbar spine and femur (equipment Hologic, Discovery WI) were performed. Statistical analysis was carried out by Fisher's exact test, simple Odds Ratio (OR), and multiple logistic regression.
  
  
  RESULTS
  Mean age of the women included in the study was 52.8 (± 10.7) years-old, 27.1% were premenopausal and 72.9% were peri/postmenopausal. Approximately 14.6% of these women exhibited osteoporosis and 35.4% had low bone mass. The following items were associated with decreased bone mass: being postmenopausal (OR=71.4; 95%CI 3.8 - 1,339.7; p<0.0001), current age over 49 years-old (OR=11.4; 95%CI 2.9 - 44.0; p=0.0002), and serum estradiol levels lower than 44.5 pg/mL (OR=18.3; 95%CI 3.4 - 97.0; p<0.0001). Having a history of liver transplantation was not associated with decreased bone mass (OR=1.4; 95%CI 0.4 - 4.3; p=0.56).
  
  
  CONCLUSIONS
  Liver transplantation was not associated with decreased bone mass in this group of climacteric women.
authors.affiliation: Department of Tocogynecology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
authors.forename: Luiz Francisco
authors.initials: LF
authors.lastname: Baccaro
authors.forename: Ilka de Fátima
authors.initials: Ide F
authors.lastname: Boin
authors.forename: Lúcia
authors.initials: L
authors.lastname: Costa-Paiva
authors.forename: Aline Garcia
authors.initials: AG
authors.lastname: Leal
authors.forename: Celso Dario
authors.initials: CD
authors.lastname: Ramos
authors.forename: Aarão Mendes
authors.initials: AM
authors.lastname: Pinto-Neto
mesh_terms: D000328:Adult; D000368:Aged; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008593:Menopause; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology*; D015995:Prevalence