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Letter
Osteoporosis is not a specific complication of primary biliary cirrhosis (PBC)
  1. A Floreani1
  1. 1Department of Surgical and Gastroenterological Sciences, University of Padova, Italy
  1. Correspondence to:
    Professor A Floreani, Department of Surgical and Gastroenterological Sciences, Via Giustiniani 2, 35128 Padova, Italy;
    annarosa.floreani{at}unipd.it

https://doi.org/10.1136/gut.50.6.898

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    Newton et al (Gut 2001;49:282–7) described a retrospective study on bone mineral density (BMD) in a large cohort of patients with primary biliary cirrhosis (PBC). The authors concluded that osteoporosis is not a specific complication of PBC, but certain weaknesses in the study design do not support this conclusion.

  • The authors did not include age and sex matched controls from the general population, or control groups with different types of liver disease.

  • A proper methodological design comparing osteoporosis in PBC and in a normal population should calculate the standardised incidence ratio of osteoporosis for the two cohorts by comparing the observed incidence versus the expected incidence. The calculation should include 95% confidence intervals according to exact Poisson limits.1

  • A logistic regression analysis including risk factors for osteoporosis (that is, age, menopausal status, smoking habits, alcohol consumption, etc) should have been performed.

    • The major drawback however is the …

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