Long term follow up of bone mineral density in patients with primary biliary cirrhosis

Aim. Osteodystrophy is a well known complication of cholestatic liver diseases such as primary biliary cirrhosis (PBC), although the factors predisposing to the development of metabolic bone disease and its natural history have not been well studied. Methods. We followed a cohort of patients, predominantly post-menopausal females, for changes in bone mineral density over a period of up to 8 years. Results. We found that most patients with PBC have relatively stable lumbar bone density over time, even in the face of progressive liver disease. Only 2 of 22 patients experienced fractures. Both of these patients had low initial bone density measurements. Conclusion. We recommend that all patients with newly diagnosed PBC undergo bone mineral density measurment so as to identify those at greatest risk of pathological fractures.