| Primary biliary cholangitis (PBC), also called primary biliary cirrhosis, is a chronic autoimmune liver disease with the pathological characteristics of progressive and non-suppurative intrahepatic cholangitis, and ultimately cirrhosis. Osteoporosis (OP) is a systematic disease characterized by a decrease in bone mass and a deterioration of the bone architecture, with an increased risk of fracture. Osteoporosis is a common complication of PBC, and the incidence increases gradually as the disease progresses. The morbidity and fracture risk are higher than the general population, which is receiving greater and greater attention. The risk factors for osteoporosis include older age, women, smoking, excessive drinking, low weight, early menopause, using steroid hormone, low physical activity and reduced intake of vitamin D and calcium. Osteoporosis secondary to PBC is caused by a variety of pathological mechanisms, in which severe bone resorption and slow bone formation play a major role. Besides, heredity, hypogonadism, fat-soluble vitamin deficiency and hyperlipidemia are also involved in the onset of osteoporosis. The prevention and treatment of osteoporosis should be started early after the diagnosis of PBC. There is no unified treatment for PBC patients with osteoporosis, and it can be treated according to the treatment criteria of senile osteoporosis and postmenopausal osteoporosis. The treatment options include bisphosphonates, hormone replacement therapy, parathyroid hormone, lipid-regulating drugs and calcitonin. This review discussed the research progress in clinical manifestation, risk factors, pathogenesis and therapy of PBC complicated with osteoporosis. |