Original Article

Journal of Bone and Mineral Metabolism

, Volume 31, Issue 6, pp 637-643

Effects of total bilirubin on the prevalence of osteoporosis in postmenopausal women without potential liver disease

  • Lu-Qin BianAffiliated withDepartment of Pneumoconiosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine
  • , Rong-Zhen LiAffiliated withDepartment of Orthopaedic Surgery, Ningbo No. 9 HospitalJoint Center, Department of Orthopaedic Surgery, Seoul Now HospitalDepartment of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine
  • , Zheng-Yun ZhangAffiliated withDepartment of Surgery, Shanghai First People’s Hospital, Shanghai Jiaotong UniversityTransplantation Research Center, Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
  • , Yan-Ji JinAffiliated withDepartment of Nursing, Seoul Now Hospital
  • , Hyung-Wook KangAffiliated withJoint Center, Department of Orthopaedic Surgery, Seoul Now Hospital
  • , Zhen-Zhu FangAffiliated withDepartment of Orthopaedic Surgery, Ningbo No. 9 Hospital
  • , Youn-Soo ParkAffiliated withDepartment of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine
  • , Yoon-Ho ChoiAffiliated withCenter for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine Email author 

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Abstract

It is still uncertain whether total bilirubin per se is a risk factor for osteoporosis in postmenopausal women and no study has so far examined this important issue. This study was designed to assess the sheer effects of total bilirubin on the prevalence of osteoporosis in postmenopausal women without potential liver disease. In the present study, postmenopausal female subjects without potential liver disease (n = 918) who underwent measurement of bone mineral density were enrolled. Correlation and logistic regression analysis were used to assess the relationship between total bilirubin and other variables. As a result, subjects with osteoporosis had a significantly lower total bilirubin level (P = 0.005). A 0.1 mg/dl increase in total bilirubin was associated with reduced odds ratio of the risk by 38 % for osteoporosis [OR 0.62 (95 % CI 0.52–0.88), P = 0.012] after adjustment for several variables. Total bilirubin was independently associated with BMD [coefficient = 0.41, 95 % CI (0.35–0.47), P < 0.001 for lumbar spine and coefficient = 0.44, 95 % CI (0.36–0.48), P < 0.001 for femur neck]. A positive correlation could be observed with significant difference between total bilirubin and z-score (r = 0.33, P < 0.001 for lumbar spine and r = 0.37, P < 0.001 for femur neck) and total bilirubin was positively correlated with serum calcium (r = 0.13, P < 0.001) as well. Therefore, this study demonstrates an independent inverse association between total bilirubin and the prevalence of osteoporosis in postmenopausal women without potential liver disease. Total bilirubin would be useful as a provisional new risk factor of osteoporosis in such a population.

Keywords

Osteoporosis Total bilirubin Bone mineral density t-score z-score