Background Primary biliary cirrhosis (PBC) is a cholestatic liver disease that may be complicated by osteoporosis whose etiology seems to be multifactorial.
Objectives To determinate the frequency of bone diseases associated to PBC and to identify the independent risk factors correlated with osteoporosis during this hepatopathy.
Methods A retrospective analysis of 66 patients (58 women and 8 men) was performed including all cases of PBC diagnosed between 1996 and 2010. Only patients who benefit from measurement of bone mineral density (BMD) were included. BMD was measured by DEXA at lomber (L2-L4) and femoral (femur neck) region. Measurement was expressed in two ways, one related to the peak bone mass (the T-score) and the other to the age-matched value (the Z-score). Both scores are expressed as the number of standard deviations by which BMD deviates from the mean value. Osteoporosis and osteopenia were defined as T score below or equal to -2,5 and between -2,5 and -1 respectively.
Results BMD was performed in 32 patients (29 women and 3 men) aged from 19 to 73 years (mean age 52,5years). Only 8 patients had normal BMD (25%). Five patients had osteopenia. Osteoporosis was found in 19 patients (60%) including 17 women and 2 men meanly aged 59,9 years. Osteoporosis was revealed by a fracture in 3 cases. PBC developed since more than one year in 70% of cases. Among the fifteen postmenopausal women, 13 had osteoporosis, 2 had osteopenia and one had a normal BMD. Biological tests showed a cholestasis in all cases of osteoporosis and in 1 case of osteopenia. Phosphocalcic assessment was normal in all cases. Histological examination revealed an advanced stage (3 or 4) in 9 cases (47%) of osteoporosis and one case of osteopenia (25%). The research of another cause of osteoporosis was negative. In univariate analysis, no factor was significantly associated with the presence of osteoporosis.
Conclusions Osteoporosis is a common complication of CBP where it appears to be related to the post menopausal state and the severity of liver disease. However, no factor was significantly associated with osteoporosis.
Disclosure of Interest None Declared
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