Hepatic osteodystrophy in primary biliary cirrhosis

Effects of medical treatment

J. S. Crippin, R. A. Jorgensen, E. R. Dickson, Keith Lindor

Research output: Contribution to journalArticle

112 Citations (Scopus)

Abstract

Objectives: Osteoporosis is a frequent extrahepatic complication of primary biliary cirrhosis. Although histologically similar to the osteoporosis commonly seen in postmenopausal females, the pathogenesis and management of bone disease in patients with primary biliary cirrhosis is poorly understood. The experience with a subgroup of patients with primary biliary cirrhosis treated with vitamin D, calcium, and estrogen supplementation was reviewed to determine the effects of medical treatment on hepatic osteodystrophy. Methods: The records of 203 women with the diagnosis of primary biliary cirrhosis were reviewed retrospectively for lumbar spine bone mineral density, menopausal status, and supplementation with vitamin D, calcium, and estrogen. Results: The 16 postmenopausal patients treated with estrogen replacement had a statistically significant increase in the lumbar spine bone mineral density at 1 yr (+0.014 ± 0.049 vs. -0.03 ± 0.046 g/cm2, p < 0.038), without a significant change in the serum bilirubin or alkaline phosphatase. In treated patients, vitamin D and calcium supplementation did not lead to significant improvement in lumbar spine bone mineral density. Conclusions: Calcium and vitamin D supplementation, even in the presence of vitamin D deficiency, do not improve lumbar spine bone mineral density in patients with primary biliary cirrhosis. Estrogen replacement in postmenopausal patients, however, does appear to improve lumbar spine bone mineral density without increasing clinical or biochemical cholestasis, a potential complication reported in animal studies. This study should serve as an impetus for a controlled trial of estrogen replacement in postmenopausal patients with primary biliary cirrhosis.

Original languageEnglish (US)
Pages (from-to)47-50
Number of pages4
JournalAmerican Journal of Gastroenterology
Volume89
Issue number1
StatePublished - 1994
Externally publishedYes

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Biliary Liver Cirrhosis
Bone Density
Spine
Liver
Vitamin D
Estrogen Replacement Therapy
Calcium
Therapeutics
Osteoporosis
Estrogens
Vitamin D Deficiency
Bone Diseases
Cholestasis
Bilirubin
Alkaline Phosphatase
Serum

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Hepatic osteodystrophy in primary biliary cirrhosis : Effects of medical treatment. / Crippin, J. S.; Jorgensen, R. A.; Dickson, E. R.; Lindor, Keith.

In: American Journal of Gastroenterology, Vol. 89, No. 1, 1994, p. 47-50.

Research output: Contribution to journalArticle

Crippin, J. S. ; Jorgensen, R. A. ; Dickson, E. R. ; Lindor, Keith. / Hepatic osteodystrophy in primary biliary cirrhosis : Effects of medical treatment. In: American Journal of Gastroenterology. 1994 ; Vol. 89, No. 1. pp. 47-50.
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