{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T03:06:21Z","timestamp":1792551981793,"version":"4.5.0"},"reference-count":50,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T00:00:00Z","timestamp":1701907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005347","name":"American Association for the Study of Liver Diseases","doi-asserted-by":"publisher","award":["Advanced\/Transplant Hepatology Award"],"award-info":[{"award-number":["Advanced\/Transplant Hepatology Award"]}],"id":[{"id":"10.13039\/100005347","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with cirrhosis are at increased risk for osteoporosis, and those who suffer a fracture are at high risk for mortality. Despite this, osteoporosis is often overlooked and undertreated. This study aimed to evaluate osteoporosis screening, management, and adverse osteoporosis medication events in patients with cirrhosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective chart review of adult outpatients with compensated and decompensated cirrhosis seen in single health system over a 6\u2010year period. Patient demographics, liver and bone health comorbidities, DEXA scan results, and medications were abstracted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 5398 patients met criteria. The cohort was predominately white (79.1%) and older (age 59). 44.4% were female. 64.6% had decompensated cirrhosis. Median MELD\u2010Na score was 12.8. 23.5% had a DEXA scan ordered, approximately 50% completed this test. Patients who were older, female, white, with more severe liver disease, and other osteoporosis risk factors were more likely to have a DEXA scan ordered. 48.5% of patients had osteopenia and 30.2% had osteoporosis on DEXA scan. Only 22.6% of patients with osteoporosis received treatment, most commonly oral bisphosphonates. Oral bisphosphonate prescription was not associated with variceal bleeding (8.4% without vs. 4.8% with,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.487).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A minority of patients with cirrhosis were screened for osteoporosis. The majority screened had osteopenia or osteoporosis on DEXA scan. Less than a quarter of patients with osteoporosis were started on treatment. Real\u2010world experience of oral bisphosphonate use did not reveal higher rates of gastrointestinal bleeding. There is room for improvement in all aspects of bone health care in cirrhosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.17823","type":"journal-article","created":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T21:38:07Z","timestamp":1701985087000},"page":"535-546","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Low screening rates and high prevalence of osteoporosis in cirrhosis: A real\u2010world retrospective analysis"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1505-9091","authenticated-orcid":false,"given":"Mary","family":"Thomson","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Scott","sequence":"additional","affiliation":[{"name":"University of Minnesota Medical School  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Trost","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Endocrinology and Metabolism University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Lake","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Lim","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0077"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2004.11.035"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00774-007-0833-1"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-0835"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/agq037"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.5812\/hepatmon.15(4)2015.26871"},{"issue":"8","key":"e_1_2_10_8_1","article-title":"Study of hepatic osteodystrophy in patients with chronic liver disease","volume":"10","author":"Karoli Y","year":"2016","journal-title":"J Clin Diagn Res"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.4103\/sjg.SJG_74_18"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.4314\/ahs.v20i4.13"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12010153"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/1423462"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20174270"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-010-0166-4"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.12.001"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2013.04.031"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-017342"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000001166"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-022-02832-y"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2022.05.048"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.13624"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000002088"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.4158\/GL-2020-0524SUPPL"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.7498"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30145"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32771"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26972"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.06.024"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2019-00221"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-3045"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.50.suppl_1.i1"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-021-07076-1"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1159\/000510981"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP161435.ESGL"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.06.049"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0183924"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/jbi\/wbac072"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000715"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2010.467"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/1460458209345900"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1136\/jamia.2009.002436"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.1996.tb00284.x"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.5114\/pg.2014.42502"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00223-013-9797-4"},{"issue":"1","key":"e_1_2_10_45_1","first-page":"1","article-title":"Prevalence of osteoporosis in cirrhosis: a systematic review and meta\u2010analysis","volume":"15","author":"Kang J","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_10_46_1","doi-asserted-by":"crossref","unstructured":"SarafraziN WambogoEA ShepherdJA.Osteoporosis or low bone mass in older adults: United States 2017\u20132018.2021.","DOI":"10.15620\/cdc:103477"},{"issue":"1","key":"e_1_2_10_47_1","first-page":"1","article-title":"The global prevalence of osteoporosis in the world: a comprehensive systematic review and meta\u2010analysis","volume":"16","author":"Salari N","year":"2021","journal-title":"J Orthopaed Surg Res"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-55603-y"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.4065\/80.2.194"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11657-013-0167-7"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11914-022-00730-1"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.17823","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T00:56:17Z","timestamp":1705884977000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.17823"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,7]]},"references-count":50,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1111\/apt.17823"],"URL":"https:\/\/doi.org\/10.1111\/apt.17823","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,7]]},"assertion":[{"value":"2023-07-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}