Osteoporosis in chronic liver disease

Accurate measurements of bone mineral content in a large series of patients with chronic liver disease have not been reported. The authors measured bone mineral content in lumbar spine trabecular bone by quantitative computerized tomography and in radial cortical bone using single photon absorptiometry in 57 unselected patients with chronic liver disease (21 CAH, 19 alcoholic, and 17 PBC). Thirteen patients (23%) had osteoporosis defined as a bone mineral content >2 SD below the mean age- and sex-matched control value. Of these, 5 had spinal osteoporosis, 11 peripheral cortical osteoporosis, and 3 both. Four patients had vertebral fractures. A similar proportion of patients had osteoporosis in each group, but spinal osteoporosis occurred mainly in steroid-treated CAH, whereas peripheral osteoporosis was commoner in PBC and alcoholic patients.