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Management of osteoporosis in liver disease.
Clin Res Hepatol Gastroenterol 2011; 35(6-7):438-45CR

Abstract

Osteoporosis resulting in a high risk for fracture is a common complication in patients with liver disease, particularly in those with chronic cholestasis and with end-stage cirrhosis. The pathogenesis of bone loss in liver patients is poorly understood but it mainly results from low bone formation as a consequence of cholestasis or the harmful effects of alcohol or iron on osteoblasts. Increased bone resorption has also been described in cholestatic women with advanced disease. The management of bone disease in liver patients is addressed to reduce or avoid the risk factors for osteoporosis and fracture. Bisphosphonates associated with supplements of calcium and vitamin D are safe and effective for increasing bone mass in patients with chronic cholestasis and after liver transplantation, though no clear achievements in descreasing the incidence of fractures have been described, probably because of the low number of patients included in the therapeutic trials. Randomized studies assessing bisphosphonates in larger series of patients, the development of new drugs for osteoporosis and the improvement in the management of liver transplant recipients may change the future.

Authors+Show Affiliations

Liver Unit, Department of Rheumatology, Hospital Clínic, CIBERhed, University of Barcelona, Barcelona, Spain.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

21546334

Citation

Guañabens, Núria, and Albert Parés. "Management of Osteoporosis in Liver Disease." Clinics and Research in Hepatology and Gastroenterology, vol. 35, no. 6-7, 2011, pp. 438-45.
Guañabens N, Parés A. Management of osteoporosis in liver disease. Clin Res Hepatol Gastroenterol. 2011;35(6-7):438-45.
Guañabens, N., & Parés, A. (2011). Management of osteoporosis in liver disease. Clinics and Research in Hepatology and Gastroenterology, 35(6-7), pp. 438-45. doi:10.1016/j.clinre.2011.03.007.
Guañabens N, Parés A. Management of Osteoporosis in Liver Disease. Clin Res Hepatol Gastroenterol. 2011;35(6-7):438-45. PubMed PMID: 21546334.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of osteoporosis in liver disease. AU - Guañabens,Núria, AU - Parés,Albert, Y1 - 2011/05/04/ PY - 2011/03/14/received PY - 2011/03/16/accepted PY - 2011/5/7/entrez PY - 2011/5/7/pubmed PY - 2011/11/2/medline SP - 438 EP - 45 JF - Clinics and research in hepatology and gastroenterology JO - Clin Res Hepatol Gastroenterol VL - 35 IS - 6-7 N2 - Osteoporosis resulting in a high risk for fracture is a common complication in patients with liver disease, particularly in those with chronic cholestasis and with end-stage cirrhosis. The pathogenesis of bone loss in liver patients is poorly understood but it mainly results from low bone formation as a consequence of cholestasis or the harmful effects of alcohol or iron on osteoblasts. Increased bone resorption has also been described in cholestatic women with advanced disease. The management of bone disease in liver patients is addressed to reduce or avoid the risk factors for osteoporosis and fracture. Bisphosphonates associated with supplements of calcium and vitamin D are safe and effective for increasing bone mass in patients with chronic cholestasis and after liver transplantation, though no clear achievements in descreasing the incidence of fractures have been described, probably because of the low number of patients included in the therapeutic trials. Randomized studies assessing bisphosphonates in larger series of patients, the development of new drugs for osteoporosis and the improvement in the management of liver transplant recipients may change the future. SN - 2210-741X UR - https://www.unboundmedicine.com/medline/citation/21546334/Management_of_osteoporosis_in_liver_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2210-7401(11)00108-2 DB - PRIME DP - Unbound Medicine ER -