Center for Medical Ethics and Health Policy Staff Publications
Publication Date
9-1-2022
Journal
Clinical Gastroenterology and Hepatology
DOI
10.1016/j.cgh.2021.09.026
PMID
34571258
PMCID
PMC8942866
PubMedCentral® Posted Date
9-1-2023
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Keywords
Bone Density, Bone Diseases, Metabolic, Cross-Sectional Studies, Female, Humans, Male, Osteoporosis, Pancreatitis, Chronic, Prevalence, Prospective Studies, Retrospective Studies, Risk Factors, osteoporosis, osteopenia, fracture, dual-energy X-ray absorptiometry
Abstract
Background & aims: Chronic pancreatitis (CP) is associated with osteopathy (osteoporosis or osteopenia). However, existing literature is mostly limited to retrospective or administrative studies that have not clearly defined the prevalence and risk factors. Our aim was to identify patient- and disease-related associations with osteopathy in a prospective cohort study of CP.
Methods: We studied 282 subjects with definitive CP enrolled in the PROCEED study who had a baseline dual-energy X-ray absorptiometry (DXA) scan. Osteopenia and osteoporosis were defined using the lowest T-scores. Clinical data were collected using standardized case report forms. Comparisons were performed with a multivariate logistic regression model with forward selection to identify risk factors for osteopathy.
Results: The majority of subjects had osteopathy on DXA scan (56.0%; 17.0% osteoporosis; 39.0% osteopenia). Subjects with osteopathy had a higher prevalence of traumatic (40.0% vs 26.4%; P = .02) and spontaneous fractures (3.9% vs 0; P = .04). On multivariate analysis, older age (odds ratio [OR], 1.29 per 5 years; 95% confidence interval [CI], 1.15-1.45), female sex (OR, 3.08; 95% CI, 1.75-5.43), white race (OR, 2.68; 95% CI, 1.20-6.01), and underweight body mass index category (OR, 7.40; 95% CI, 1.56-34.99) were associated with higher probability of osteopathy. There were no significant associations between osteopathy and other patient and disease-related features of CP.
Conclusion: In the largest study of patients with CP who underwent DXA screening, the majority had osteopathy. There are overlapping risk factors with osteopathy in the general population, but the high prevalence in men and younger women supports the need for future investigations into the mechanisms of bone loss in CP.
Clinicaltrials: gov number, NCT03099850.