Background Chronic pancreatitis is associated with risk factors that may negatively affect bone metabolism and increase risk of developing osteoporosis and low energy fractures. We evaluated the association of osteoporosis in Danish chronic pancreatitis patients with a number of predefined risk factors besides pancreatic exocrine insufficiency. Methods This was a cross-sectional study of 67 outpatients conducted at a tertiary referral centre. Dual-energy x-ray absorptiometry scan was used to examine bone mineral density for the columnar spine and femoral neck. The primary outcome was to identify risk factors associated with osteoporosis in chronic pancreatitis. Several clinical and demographic parameters, including exocrine pancreatic insufficiency, vitamin-D level, as well as muscle function and strength were analysed for association with bone mineral density. Results The median age of patients was 60 years (IQR 51-68) and 40% were women. The prevalence of osteoporosis was 26.9% in patients compared to 9.1% in Danish citizens (OR 2.4 [95% CI; 1.0-5.7]; P=0.042). Muscle function (Timed Up and Go Test), 25(OH)-Vitamin-D level, and body mass index were independently associated with bone mineral density at the femoral neck (all p<0.001), while diabetes (P=0.03) and exocrine pancreatic insufficiency (P=0.006) were independently associated with bone mineral density in the columnar spine. Conclusion The risk of osteoporosis in chronic pancreatitis outpatients associates with several modifiable risk factors in addition to exocrine pancreatic insufficiency. This information should be implemented in outpatient monitoring strategies to improve bone health and decrease risk of low energy fractures.
Louise Kuhlmann, Jakob L Poulsen, Marianne Køhler, Henrik H Rasmussen, Peter Vestergaard, Asbjørn M Drewes, Søren S Olesen
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