Osteoporosis and bone fractures in alcoholic liver disease:A meta-analysis

AIM: To evaluate the association between alcoholic liver disease(ALD) and bone fractures or osteoporosis. METHODS: Non-randomized studies were identified from databases(Pub Med, EMBASE, and the Cochrane Library). The search was conducted using Boolean operators and keywords, which included "alcoholic liver diseases", "osteoporosis", or "bone fractures". The prevalence of any fractures or osteoporosis, and bone mineral density(BMD) were extracted and analyzed using risk ratios and standardized mean difference(SMD). A random effects model was applied. RESULTS: In total, 15 studies were identified and analyzed. Overall, ALD demonstrated a RR of 1.944(95%CI: 1.354-2.791) for the development of bone fractures. However, ALD showed a RR of 0.849(95%CI: 0.523-1.380) for the development of osteoporosis. BMD was not significantly different between the ALD and control groups, although there was a trend toward lower BMD in patients with ALD(SMD in femur-BMD:-0.172, 95%CI:-0.453-0.110; SMD in spine-BMD:-0.169, 95%CI:-0.476-0.138). Sensitivity analyses showed consistent results. CONCLUSION: Current publications indicate significant associations between bone fractures and ALD, independent of BMD or the presence of osteoporosis.