Document Detail

Ursodeoxycholic acid enhances fractional calcium absorption in primary biliary cirrhosis.
MedLine Citation:
PMID:  12181628     Owner:  NLM     Status:  MEDLINE    
Bone disease is a frequently reported complication in primary biliary cirrhosis (PBC), but its pathogenesis is poorly understood. Calcium malabsorption has been considered as an important contributing factor. Ursodeoxycholic acid (UDCA) is the treatment of choice in PBC, improving survival, but its effect on calcium absorption is unknown. In this study, we have measured fractional calcium absorption, using a single isotope method, in a group of female PBC patients (median age: 60 years, range: 46-78 years) and age-matched female controls (median age: 58 years, range: 36-74). Bone mineral density (BMD) in PBC patients was significantly lower than age-matched controls (g/cm(2) +/- SEM; lumbar spine: controls 1.139+/-0.028, PBC patients 1.004+/-0.026, p = 0.0028; femoral neck: controls 0.944+/-0.034, PBC patients 0.819+/-0.023, p = 0.0032). Twenty two PBC patients, who were not vitamin D-deficient, were off and on UDCA for approximately 1 month and approximately 8 weeks, respectively. Fractional calcium absorption in PBC patients prior to UDCA treatment (mean +/- SEM, 33.8+/-2.6%) was significantly lower than controls (52.0+/-2.4%, p<0.001). Following UDCA therapy, fractional calcium absorption increased significantly (Off UDCA: 33.1+/-2.6%, On UDCA: 36.6+/-2.5%, p<0.0058). Osteocalcin levels were significantly raised in the PBC group (mean +/- SEM, ng/ml, 41.4+/-2.02) compared to controls (31.1+/-2.64, p = 0.002). There were no differences in parathyroid hormone (PTH) or 25-hydroxyvitamin D levels between these two groups or following UDCA therapy. In conclusion, we found that PBC patients display low spinal and femoral neck BMD, reduced fractional calcium absorption, and elevated plasma osteocalcin. The calcium malabsorption is corrected partially by UDCA therapy. Long-term studies are required to determine whether this effect can be sustained, and whether a sustained increase in fractional calcium absorption can translate into a favorable change in bone strength in patients with PBC.
A Verma; J D Maxwell; L Ang; T Davis; S Hodges; T C Northfield; M Zaidi; M Pazianas
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA     Volume:  13     ISSN:  0937-941X     ISO Abbreviation:  Osteoporos Int     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-15     Completed Date:  2002-10-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9100105     Medline TA:  Osteoporos Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  677-82     Citation Subset:  IM    
Department of Medicine, Calderdale Royal Hospital, Halifax, UK.
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MeSH Terms
Absorptiometry, Photon / methods
Bone Density / drug effects*
Bone Diseases, Metabolic / drug therapy,  etiology*,  metabolism*
Calcium / pharmacokinetics*
Case-Control Studies
Cholagogues and Choleretics / therapeutic use*
Liver Cirrhosis, Biliary / complications,  drug therapy*,  metabolism
Middle Aged
Osteocalcin / metabolism
Ursodeoxycholic Acid / therapeutic use*
Reg. No./Substance:
0/Cholagogues and Choleretics; 104982-03-8/Osteocalcin; 128-13-2/Ursodeoxycholic Acid; 7440-70-2/Calcium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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