The association between liver cirrhosis and fracture risk: A systematic review and meta-analysis

Clin Endocrinol (Oxf). 2018 Oct;89(4):408-413. doi: 10.1111/cen.13762. Epub 2018 Aug 9.

Abstract

Objective: Liver cirrhosis (LC) was associated with an increased risk of osteoporosis; however, the association between LC and fracture risk was inconclusive. Therefore, this systematic review and meta-analysis aims to explore the association between LC and fracture risk.

Design: To identify related literature, a systematic search of PubMed, EMBASE, Web of science and the Cochrane Library from 1965 to July 2017 without language limitation was performed. The random-effects model described by DerSimonian and Laird was used to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs).

Results: Eventually, 5 cohort and 3 case-control studies were identified, which included 321 035 subjects and 31 272 fracture cases. The pooled OR of the association between LC and any fracture risk, hip fracture, spine/trunk fracture and limb fracture was 1.94 (95% CI, 1.59-2.37), 2.11 (95% CI, 1.34-3.32), 2.00 (95% CI, 1.50-2.67) and 1.82 (95% CI, 1.65-2.01), respectively.

Conclusion: In conclusion, this study indicates that cirrhotic patients have an increased risk of fracture. Preventive measures should be instituted as early as possible.

Keywords: cirrhosis; fracture; meta-analysis; primary biliary cirrhosis.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Animals
  • Confidence Intervals
  • Fractures, Bone / epidemiology*
  • Hip Fractures / epidemiology
  • Humans
  • Liver Cirrhosis / epidemiology*
  • Odds Ratio
  • Risk Factors