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.

中文翻译：

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慢性胰腺炎中骨病的高患病率：PROCEED 研究的横断面分析

背景与目标

慢性胰腺炎（CP）与骨病（骨质疏松症或骨质减少）有关。然而，现有文献大多仅限于回顾性或管理性研究，尚未明确界定患病率和危险因素。我们的目的是在一项 CP 前瞻性队列研究中确定患者和疾病与骨病的相关性。

方法

我们研究了参加 PROCEED 研究的 282 名患有明确 CP 的受试者，他们进行了基线双能 X 射线吸收测定法 (DXA) 扫描。骨质减少和骨质疏松症使用最低 T 分数来定义。使用标准化病例报告表收集临床数据。使用具有正向选择的多变量逻辑回归模型进行比较，以确定骨病的危险因素。

结果

大多数受试者在 DXA 扫描中患有骨病（56.0%；17.0% 骨质疏松；39.0% 骨质减少）。患有骨病的受试者外伤性骨折（40.0% vs 26.4%； P  = .02）和自发性骨折（3.9% vs 0；P = .04）的发生率较高 。多变量分析显示，年龄较大（比值比 [OR]，每 5 年 1.29；95% 置信区间 [CI]，1.15–1.45）、女性（OR，3.08；95% CI，1.75–5.43）、白人（ OR, 2.68; 95% CI, 1.20–6.01) 和体重不足指数类别 (OR, 7.40; 95% CI, 1.56–34.99) 与较高的骨病可能性相关。骨病与其他患者以及 CP 疾病相关特征之间没有显着关联。

结论

在对接受 DXA 筛查的 CP 患者进行的最大规模研究中，大多数患者患有骨病。在一般人群中，骨病存在重叠的危险因素，但男性和年轻女性的高患病率支持未来对 CP 骨质流失机制进行研究的必要性。ClinicalTrials.gov 编号，NCT03099850。