Since primary biliary cirrhosis (PBC) is currently diagnosed in the early stages, steomalacia is very uncommon, while osteoporosis is the metabolic bone disease observed in this liver disease. The mechanisms resulting in osteoporosis in PBC are not completely elucidated, although the bone disease emerges from a combination of decreased bone formation and increased resorption. Although genetic susceptibility has been proposed as a factor for osteoporosis in PBC, the VDR, COLIA1 and IGF-1 polymorphisms either do not influence the development of osteoporosis in PBC or have only a minor role in it. The duration as well the severity of cholestasis are the main causes for osteoporosis since they are associated with the degree of bone loss. Menopause is not an independent risk factor for low bone mass in PBC. Osteoporosis is a common complication observed in patients with primary biliary cirrhosis (PBC), with a prevalence of around 25%. The pathogenesis of bone loss in PBC is not well understood, since low bone formation and high resorption have been described. Bone disease is influenced by the duration and severity of the disease and oestrogen deficiency secondary to menopause. Genetic susceptibility has also been considered for osteoporosis in PBC, including vitamin D receptor genotypes, the gene encoding collagen type Iα1 and insulin growth factor 1 gene microsatellite repeat polymorphism. Based on current evidence, the proposed genotypes either do not influence the development of osteoporosis in PBC or play only a minor role in it. The duration as well the severity of cholestasis are the main factors for such a disturbance since they are associated with the degree of bone loss. These features may exceed the potential effect of gene polymorphisms on osteoporosis in PBC.
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s et al. (2005) studied this question.