Osteoporosis

GENERAL PRINCIPLES

• Osteoporosis is defined as a decrease in the amount of bone (mainly trabecular bone), leading to a decrease in its structural integrity and increase in the risk of fractures.

• The relative risk of osteopenia in cholestasis is 4.4 times greater than the general population, matched for age and gender. It is particularly common in cholestasis caused by PBC.¹⁷

DIAGNOSIS

Bone mineral density should be measured by dual-energy x-ray absorptiometry in all patients at the time of diagnosis and during follow-up (every 1-2 years).

TREATMENT

Treatment of bone disease includes weight-bearing exercise, oral calcium supplementation (1.0-1.5 g/d), bisphosphonate therapy, and vitamin D supplementation.