Low body mass index and use of corticosteroids, but not cholestasis, are risk factors for osteoporosis in patients with chronic liver disease

Background/Aims: Metabolic bone disease is known to complicate chronic live r disease. In a cross-sectional, controlled study we have studied the preva lence of osteoporosis in patients with various types of chronic liver disea se. We also identified risk factors predisposing to osteoporosis in this pa tient group. Methods: Seventy-two hospitalised patients, 46 females and 26 males, were i ncluded. Age- and sex-matched individuals from the background population se rved as controls. Bone mineral density was measured by dual energy X-ray ab sorptiometry at the lumbar spine and femoral neck, Results: Bone mineral density was significantly lower in patients with chro nic liver disease than in controls at the lumbar spine (Z-score: -0.35 SD+/ -1.36 vs, 0.26 SD+/-1.19, p<0.01) but not at the femoral neck (Z-score: -0. 18 SD+/-1.48 vs. 0.17 SD+/-1.08, NS). Patients with cholestatic chronic liv er disease did not have lower bone mineral density compared with patients w ith non-cholestatic chronic liver disease (Z-score: -0.35 SD+/-1.30 vs. -0. 34 SD+/-1.45). Osteoporosis was found in 30% of the patients and 15% of the controls, respectively. In a multivariate regression analysis on risk fact ors in the patient group, the following factors were associated with osteop orosis: use of corticosteroids (odds ratio=18.9; p<0.01), low body mass ind ex (odds ratio=14,1; p=0,001), high age and female sex, Conclusion: Patients with chronic liver disease are at risk of developing o steoporosis. Risk factors for osteoporosis in chronic liver disease are low body mass index and corticosteroid therapy, in addition to high age and fe male sex, Cholestatic liver disease per se is not associated with an increa sed risk for osteoporosis.