{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T22:13:48Z","timestamp":1791843228121,"version":"4.3.4"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,3,5]],"date-time":"2023-03-05T00:00:00Z","timestamp":1677974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern Med"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Morbidity in primary biliary cholangitis (PBC) is multifactorial. Osteoporosis related to cholestasis is an extrahepatic complication of PBC. It is not fully established to what extent people with PBC have an increased risk for fractures, and if mortality after a fracture is increased, compared to the general population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All Swedish people with PBC diagnosed between 2001 and 2016 were identified from the National Swedish Patient Register using ICD\u201010 codes. Incident fractures were ascertained in the same register and compared to matched controls from the Swedish general population (1:10 for age, sex, and municipality). Cox regression was used to investigate the rates of fractures and postfracture mortality. The cumulative incidence of fractures was calculated while accounting for competing risks (death or liver transplantation).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      People with PBC (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a03980) showed a higher risk of fractures at all\u2010time points during follow\u2010up compared to matched controls (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a037,196), which was seen both in men and women. At 5 years of follow\u2010up, the cumulative incidence of any fracture in people with PBC was 16.8% (95% confidence interval [CI]\u00a0=\u00a015.6\u201318.1), compared to 11.6% (95%CI\u00a0=\u00a011.3\u201312.0) in controls. The rate of osteoporotic fractures was particularly high (adjusted Hazard ratio [aHR]\u00a0=\u00a01.9; 95%\u00a0=\u00a0CI 1.7\u20132.0). The 30\u2010day as well as the 1\u2010year mortality after a fracture was significantly higher in people with PBC compared to controls that also experienced a fracture (aHR\u00a0=\u00a02.2; 95%CI\u00a0=\u00a01.5\u20133.2; aHR\u00a0=\u00a02.0; 95%CI 1.7\u20132.4).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>People with PBC have a significantly higher risk of fractures and postfracture mortality compared to matched controls from the general population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/joim.13624","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T23:42:03Z","timestamp":1677195723000},"page":"164-177","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Risk of fractures and postfracture mortality in 3980 people with primary biliary cholangitis: A population\u2010based cohort study"],"prefix":"10.1111","volume":"294","author":[{"given":"Johanna","family":"Sch\u00f6nau","sequence":"first","affiliation":[{"name":"Department of Internal Medicine I University Medical Center Mainz  Langenbeckstrasse, 1 Mainz Rhineland\u2010Palatinate 55131 Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3634-6591","authenticated-orcid":false,"given":"Axel","family":"Wester","sequence":"additional","affiliation":[{"name":"Department of Medicine Huddinge Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4224-4703","authenticated-orcid":false,"given":"J\u00f6rn M.","family":"Schattenberg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I University Medical Center Mainz  Langenbeckstrasse, 1 Mainz Rhineland\u2010Palatinate 55131 Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8474-1759","authenticated-orcid":false,"given":"Hannes","family":"Hagstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Medicine Huddinge Karolinska Institutet  Stockholm Sweden"},{"name":"Unit of Hepatology, Department of Upper GI Diseases Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i14.2459"},{"key":"e_1_2_9_3_1","article-title":"The role of vitamin d in primary biliary cirrhosis: possible genetic and cell signaling mechanisms","volume":"2013","author":"LN KV","year":"2013","journal-title":"Gastroenterol Res 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