Guidelines on the management of osteoporosis associated with chronic liver disease

Peak bone mass is determined by genetic factors, hormonal status, diet, and exercise, and men have a higher peak bone mass than women. [...]irrespective of other factors, the incidence of osteoporosis increases in the elderly as age related bone loss is a normal phenomenon. Current research requirements include: a prospective study of the prevalence of fractures in patients with chronic liver disease; a study of the prevalence of osteoporosis in patients with all stages of PBC compared with sex and age matched controls; a prospective study of the prevalence of hypogonadism in males with cirrhosis with and without osteoporosis; assessment of the safety of restoring testosterone levels to the normal range in patients with cirrhosis; and a two year placebo controlled randomised trial of the effects of intervention (a bisphosphonate proven to have antifracture efficacy in postmenopausal women or HRT) on BMD in patients with cirrhosis. 12.0 APPENDIX Contributors The Consensus Workshop Group Hepatology: D Jones, Freeman Hospital, Newcastle upon Tyne; J Collier, John Radcliffe Hospital, Oxford; R Chapman, John Radcliffe Hospital, Oxford; A MacGilchrist, Royal Infirmary, Edinburgh; A Burroughs, Royal Free Hospital, London; G Alexander, Addenbrookes Hospital, Cambridge; M Ninkovic, Addenbrookes Hospital, Cambridge; E Elias, Queen Elizabeth Hospital, Birmingham; A Dhawan, Kings College Hospital, London; M Davies, St James Hospital, Leeds; P Mills, Glasgow; D Gleeson, Sheffield; N Sheron, Southampton.