Prevalence of osteoporosis in autoimmune hepatitis

Objective: This study aimed to determine the prevalence of osteoporosis in patients with autoimmune hepatitis (AIH) and variant syndromes and to evaluate the clinical factors associated with osteoporosis development. Materials and Methods: A total of 80 patients with a confirmed diagnosis of AIH and overlap syndromes who were followed in the Cerrahpaşa Gastroenterology Clinic were retrospectively analyzed. Thirteen patients were excluded due to insufficient data, and the study included 67 patients. Demographic data, biochemical parameters, bone mineral density (BMD) results, medications used, and clinical factors associated with osteoporosis were assessed. Results: Among 67 patients, 18.2% had osteoporosis, and 54.5% had osteopenia. The relationship between osteoporosis and age, gender, body mass index (BMI), autoantibody positivity, and biochemical parameters was evaluated. Postmenopausal patients showed a significantly higher prevalence of osteoporosis. Additionally, higher fibrosis stages were associated with increased bone loss, while longer remission duration was linked to lower osteoporosis rates. Although osteoporosis and osteopenia were more frequent in patients receiving corticosteroids, there was no statistically significant association between steroid use, steroid duration, number of relapses requiring steroids, and osteoporosis development (p>0.05). Conclusion: Osteoporosis in AIH patients is a multifactorial condition that cannot be attributed solely to steroid use. Inflammatory burden, fibrosis stage, menopause, low BMI, and cholestatic components may contribute to osteoporosis development. Therefore, regular screening for osteoporosis and an individualized follow-up and treatment plan are recommended for AIH patients.