Other studies suggested that VDR polymorphisms can contribute to the development of osteoporosis in patients with PBC [35]; however on the grounds of recent evidence, it is more likely that the cholestasis itself is the main factor of hepatic osteodystrophy, and the indentified polymorphisms play little or no role in the pathogenesis of this complication in patients with PBC [36]. This evidence concerns the gene VDR and primary biliary cholangitis.