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Osteoporosis primary biliary cirrhosis

Chen-Yi Liao, Chi-Hsiang Chung, Pauling Chu, Kuang-Yu Wei, Tseng-Min Feng, Fu-Huang Lin, Chang-Huei Tsao, Chia-Chao Wu, Wu-Chien Chien
BACKGROUND: We evaluated the risk of osteoporosis in patients with primary biliary cirrhosis (PBC) using a nationwide population-based dataset. METHODS: In a cohort study of 986,713 individuals, we selected 2,493 PBC patients who were aged 18 years or older and had been diagnosed with PBC, based on the International Classification of Disease (ICD-9-CM) codes 571.6, during 20002010. The control cohort comprised 9,972 randomly selected, propensity matched patients (by age, gender, and index date), without PBC...
2018: PloS One
Junyu Fan, Qian Wang, Lingyun Sun
The relationship between primary biliary cholangitis (PBC, previously termed primary biliary cirrhosis) and risks of osteoporosis remains controversial. This meta-analysis was designed to comprehensively analyze the association between PBC and osteoporosis. We conducted a systematic literature search of the PubMed, EMBASE, and Web of Science. Either fixed or random effects models were applied to assess bone mineral density (BMD), osteoporosis rates, and fractures in PBC patients and normal controls. A total of eight studies were included (including 1643 PBC patients and 10,921 controls)...
November 2017: Clinical Rheumatology
Anna Seki, Fusao Ikeda, Hirokazu Miyatake, Koichi Takaguchi, Shosaku Hayashi, Toshiya Osawa, Shin-Ichi Fujioka, Ryoji Tanaka, Masaharu Ando, Hiroyuki Seki, Yoshiaki Iwasaki, Kazuhide Yamamoto, Hiroyuki Okada
BACKGROUND AND AIM: It remains unclear whether primary biliary cholangitis (PBC) represents a risk factor for secondary osteoporosis. METHODS: A case-control study was conducted to examine bone mineral density and bone turnover markers in middle-aged postmenopausal PBC patients without liver cirrhosis. We compared the incidence of low bone mineral density between propensity-score matched subgroups of PBC patients and healthy controls, and investigated the mechanisms underlying unbalanced bone turnover in terms of the associations between bone turnover markers and PBC-specific histological findings...
January 23, 2017: Journal of Gastroenterology and Hepatology
Lisa M Glass, Grace Li-Chun Su
Primary biliary cirrhosis (PBC) is a liver-specific autoimmune disease that primarily affects women (female-to-male ratio, 10:1) between 40 and 60 years of age. Metabolic bone disease is a common complication of PBC, affecting 14% to 52% of patients, depending on the duration and severity of liver disease. The osteoporosis seen in PBC seems mainly due to low bone formation, although increased bone resorption may contribute. Treatment of osteoporosis consists primarily of antiresorptive agents. Additional large prospective, long-term studies in patients with PBC are needed to determine efficacy in improving bone density as well as reducing fracture risk...
June 2016: Gastroenterology Clinics of North America
Ruqi Tang, Yiran Wei, Zhiqiang Li, Haoyan Chen, Qi Miao, Zhaolian Bian, Haiyan Zhang, Qixia Wang, Zhaoyue Wang, Min Lian, Fan Yang, Xiang Jiang, Yue Yang, Enling Li, Michael F Seldin, M Eric Gershwin, Wilson Liao, Yongyong Shi, Xiong Ma
Primary biliary cirrhosis (PBC), a chronic autoimmune liver disease, has been associated with increased incidence of osteoporosis. Intriguingly, two PBC susceptibility loci identified through genome-wide association studies are also involved in bone mineral density (BMD). These observations led us to investigate the genetic variants shared between PBC and BMD. We evaluated 72 genome-wide significant BMD SNPs for association with PBC using two European GWAS data sets (n = 8392), with replication of significant findings in a Chinese cohort (685 cases, 1152 controls)...
February 4, 2016: Scientific Reports
Shintaro Yamaguchi, Tatsuya Maruyama, Shu Wakino, Hirobumi Tokuyama, Akinori Hashiguchi, Shinichiro Tada, Koichiro Homma, Toshiaki Monkawa, James Thomas, Kazutoshi Miyashita, Isao Kurihara, Tadashi Yoshida, Konosuke Konishi, Koichi Hayashi, Matsuhiko Hayashi, Hiroshi Itoh
BACKGROUND: Primary biliary cirrhosis (PBC) is an immune-mediated chronic cholestatic liver disease, characterized by increased concentrations of serum IgM and the presence of circulating anti-mitochondrial antibodies. Although bone diseases such as osteoporosis or osteodystrophy are commonly associated with PBC, osteomalacia which is caused by abnormal vitamin D metabolism, mineralization defects, and phosphate deficiency has not been recognized as a complication of PBC. CASE PRESENTATION: We report the case of a 49-year-old Japanese woman who complained of multiple fractures...
2015: BMC Nephrology
Hiromi Ishibashi, Atsumasa Komori
Primary biliary cirrhosis(PBC)is a chronic cholestatic liver disease and the association of osteoporosis is high. In this paper, the practical guidelines for PBC of Japan as well as those of America(AASLD)and Europe(EASL)are mentioned. Description of each guideline is essentially the same;taking sufficient calcium(1,000~1,200 mg/day)with vitamin D and weight-bearing exercise, and thereafter medication such as alendronate is recommended.
November 2015: Clinical Calcium
Hidetaka Shibata, Kazuhiko Nakao
Primary biliary cirrhosis(PBC)is a chronic autoimmune cholestatic liver disease. Metabolic bone disease is recognized in a complication of chronic liver disease, particularly in PBC. Bone disease in PBC includes osteoporosis and, osteomalacia which is more frequent in advanced liver disease. It is important that PBC occurs mainly in middle-aged women who are highest risk group in primary osteoporosis. In patients with PBC, the dysfunction in enterohepatic circulation of bile acids is associated with the impaired absorption of fats and fat soluble vitamins...
November 2015: Clinical Calcium
Hisanori Suzuki
Bone complication occurs in patients with alcoholic hepatitis, chronic hepatitis C, primary biliary cirrhosis(PBC), primary sclerosing cholangitis(PSC)or post liver transplant. Prevalence of osteoporosis and fracture risk is high in these diseases. Nonalcoholic fatty liver disease(NAFLD)and non-alcoholic steatohepatitis(NASH)is increasing in prevalence. Relation of NAFLD/NASH with osteoporosis, however, is not well known, and further investigation is needed.
November 2015: Clinical Calcium
Joanna Raszeja-Wyszomirska, Robert Kucharski, Marta Zygmunt, Krzysztof Safranow, Tomasz Miazgowski
BACKGROUND: Osteoporosis occurs frequently in patients with chronic cholestatic liver diseases, yet data are scarce regarding the prevalence of osteoporosis and fragility fractures and their impact on Health-Related Quality of Life (HRQoL) in Primary Sclerosing Cholangitis (PSC). OBJECTIVES: We aimed to assess Bone Mineral Density (BMD), physical activity and incidence of fragility fractures in patients with PSC. We also sought associations between prior fractures and HRQoL...
April 2015: Hepatitis Monthly
Treta Purohit, Mitchell S Cappell
Primary biliary cirrhosis (PBC) is an autoimmune, slowly progressive, cholestatic, liver disease characterized by a triad of chronic cholestasis, circulating anti-mitochondrial antibodies (AMA), and characteristic liver biopsy findings of nonsuppurative destructive cholangitis and interlobular bile duct destruction. About 10% of PBC patients, however, lack AMA. A variant, called PBC-autoimmune hepatitis (AIH) overlap, is characterized by the above findings of PBC together with findings of elevated serum alanine aminotransferase, elevated serum immunoglobulin G, and circulating anti-smooth muscle antibodies, with liver biopsy demonstrating periportal or periseptal, lymphocytic, piecemeal necrosis...
May 8, 2015: World Journal of Hepatology
Angelo Gatta, Alberto Verardo, Marco Di Pascoli, Sandro Giannini, Massimo Bolognesi
Metabolic disturbances of bone are frequent in patients with chronic liver disease. The prevalence of osteoporosis among patients with advanced chronic liver disease is reported between 12% and 55%; it is higher in primary biliary cirrhosis. All patients with advanced liver disease should be screened for osteoporosis with a densitometry, especially if the etiology is cholestatic and in the presence of other risk factors. Clinical relevance of hepatic osteodystrophy increases after liver transplantation. After liver transplant, a rapid loss of bone mineral density can be detected in the first 6 months, followed by stabilization and slight improvement of the values...
September 2014: Clinical Cases in Mineral and Bone Metabolism
Joanna Raszeja-Wyszomirska, Tomasz Miazgowski
Osteoporosis is a metabolic bone disease associated with a reduction in bone mass and deterioration of bone architecture, leading to increased fragility and subsequent low-trauma fractures in the vertebral column, hip, forearm and other bones. In literature, metabolic bone diseases such as osteoporosis and osteomalacia have been recognised as a complication of chronic liver disease, although the mechanisms of this association remain unclear. An increasing body of research data indicates a strong relationship between osteoporosis and primary biliary cirrhosis (PBC), which mainly results from early diagnosis of the disease, usually when it is still asymptomatic...
2014: Przegla̜d Gastroenterologiczny
Albert Parés
Despite the presumed immunological pathogenesis of primary biliary cirrhosis, no clear or even harmful consequences resulted from some specific treatments addressed to modify the immunological condition. However, ursodeoxycholic acid (UDCA; 13-16 mg/kg/d) has clear favorable effects not only by improving biochemical cholestasis, but also by delaying the histological progression. Long -term treatment with UDCA is associated with excellent survival, free of transplantation in cases showing biochemical response at one year...
August 2014: Seminars in Liver Disease
Kate D Williamson, Roger W Chapman
Primary sclerosing cholangitis (PSC) is a chronic, cholestatic liver disease caused by diffuse inflammation and fibrosis that can involve the entire biliary tree. It is a progressive disorder which can ultimately lead to biliary cirrhosis, portal hypertension and hepatic failure. PSC is a complex genetic disorder with male predominance. Environmental predisposing factors include non-smoking. It is closely associated with inflammatory bowel disease (IBD), particularly ulcerative colitis, which occurs in about two thirds of PSC cases...
2014: Digestive Diseases
Paul Angulo
No abstract text is available yet for this article.
December 2013: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Núria Guañabens, Anna Monegal, Dacia Cerdá, África Muxí, Laia Gifre, Pilar Peris, Albert Parés
UNLABELLED: Osteoporosis resulting in bone fractures is a complication in patients with primary biliary cirrhosis (PBC). Once-weekly alendronate improves bone mass and is well tolerated in these patients, but there is a concern because of poor compliance. Therefore, the efficacy, adherence, and safety of monthly ibandronate (150 mg) with weekly alendronate (70 mg) were compared in a randomized, 2-year study in 42 postmenopausal women with PBC and osteoporosis. Bone mineral density (BMD) of the lumbar spine and proximal femur (by DXA), liver function, and bone markers were measured at entry and every 6 months over 2 years...
December 2013: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Tariq Iqbal, Mukarram A Zaidi, George A Wells, Jacob Karsh
BACKGROUND AND AIM: To evaluate presence of sero-negative spondyloarthritis (SpA) in celiac disease (CD) patients, and whether compliance with a gluten free diet (GFD) improved arthritis manifestations in these patients. METHODS: We undertook a prospective, questionnaire based, cross-sectional cohort study to evaluate the presence or absence of SpA simultaneously in both CD and non-CD cohorts. RESULTS: 356/590 (60.3%) patients with CD participated in this study...
January 2013: Journal of Gastroenterology and Hepatology
A Alcalde Vargas, J M Pascasio Acevedo, I Gutiérrez Domingo, R García Jiménez, J M Sousa Martín, M T Ferrer Ríos, M Sayago Mota, A Giráldez Gallego, M A Gómez Bravo
BACKGROUND: We performed a retrospective study to examine the prevalence of bone disease (BD) among cirrhotic patients being evaluated for liver transplantation (OLT) using bone densitometry dual-energy x-ray absorptiometry in the hip/femoral neck and lumbar spine. The associations of BD with demographic and clinical data, disease etiology and liver function were studied by univariate and multivariate logistic regression analyses. Osteopenia and osteoporosis were defined by World Health Organization criteria...
July 2012: Transplantation Proceedings
Germán López-Larramona, Alfredo J Lucendo, Sonia González-Castillo, José M Tenias
Hepatic osteodystrophy (HO) is the generic term defining the group of alterations in bone mineral metabolism found in patients with chronic liver disease. This paper is a global review of HO and its main pathophysiological, epidemiological and therapeutic aspects. Studies examining the most relevant information concerning the prevalence, etiological factors, diagnostic and therapeutic aspects involved in HO were identified by a systematic literature search of the PubMed database. HO generically defines overall alterations in bone mineral density (BMD) (osteoporosis or osteopenia) which appear as a possible complication of chronic liver disease...
December 27, 2011: World Journal of Hepatology
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