TY - JOUR
T1 - Bone disease in patients with primary sclerosing cholangitis
AU - Angulo, Paul
AU - Grandison, Garfield A.
AU - Fong, Derek G.
AU - Keach, Jill C.
AU - Lindor, Keith D.
AU - Bjornsson, Einar
AU - Koch, Alvaro
N1 - Funding Information:
Funding Supported by grant R01 DK82426 (to P.A.).
PY - 2011/1
Y1 - 2011/1
N2 - Background & Aims: Osteopenic bone disease occurs frequently among patients with chronic liver disease but has not been well studied in those with primary sclerosing cholangitis (PSC). We investigated the prevalence, rate of progression, and independent predictors of bone disease in a large number of patients with all stages of PSC. Methods: Bone mineral density of the lumbar spine, hip, and total body was measured yearly for 10 years in 237 patients with PSC. Results: Osteoporosis (T-score less than 2.5) was found in 15% of patients and occurred 23.8-fold (95% confidence interval [CI], 4.6122.8) more frequently in those with PSC than expected from a matched population. By multivariate analysis, age 54 years or older (odds ratio [OR], 7.8; 95% CI, 3.318.3), body mass index ≤24 kg/m2 (OR, 4.9; 95% CI, 1.912.6), and inflammatory bowel disease for <19 years (OR, 3.6; 95% CI, 1.58.4) correlated with the presence of osteoporosis. Osteoporosis was present in 75% of patients with all 3 risk factors but in only 3.1% of those without all of them. Patients with PSC lost 1% of bone mass per year; this rate of bone loss was significantly associated with duration of inflammatory bowel disease. Conclusions: Osteoporosis occurs frequently among patients with PSC. Old age, low body mass index, and long duration of inflammatory bowel disease can be used to identify patients with PSC who might derive the most benefit from measurements of bone density and treatments for bone diseases.
AB - Background & Aims: Osteopenic bone disease occurs frequently among patients with chronic liver disease but has not been well studied in those with primary sclerosing cholangitis (PSC). We investigated the prevalence, rate of progression, and independent predictors of bone disease in a large number of patients with all stages of PSC. Methods: Bone mineral density of the lumbar spine, hip, and total body was measured yearly for 10 years in 237 patients with PSC. Results: Osteoporosis (T-score less than 2.5) was found in 15% of patients and occurred 23.8-fold (95% confidence interval [CI], 4.6122.8) more frequently in those with PSC than expected from a matched population. By multivariate analysis, age 54 years or older (odds ratio [OR], 7.8; 95% CI, 3.318.3), body mass index ≤24 kg/m2 (OR, 4.9; 95% CI, 1.912.6), and inflammatory bowel disease for <19 years (OR, 3.6; 95% CI, 1.58.4) correlated with the presence of osteoporosis. Osteoporosis was present in 75% of patients with all 3 risk factors but in only 3.1% of those without all of them. Patients with PSC lost 1% of bone mass per year; this rate of bone loss was significantly associated with duration of inflammatory bowel disease. Conclusions: Osteoporosis occurs frequently among patients with PSC. Old age, low body mass index, and long duration of inflammatory bowel disease can be used to identify patients with PSC who might derive the most benefit from measurements of bone density and treatments for bone diseases.
KW - Autoimmune Liver Disease
KW - Cholestatic Liver Disease
KW - Inflammatory Bowel Disease
KW - Osteoporosis
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U2 - 10.1053/j.gastro.2010.10.014
DO - 10.1053/j.gastro.2010.10.014
M3 - Article
C2 - 20955707
AN - SCOPUS:78650504761
SN - 0016-5085
VL - 140
SP - 180
EP - 188
JO - Gastroenterology
JF - Gastroenterology
IS - 1
ER -