115 Bone Health in Chronic Pancreatitis: A Pilot Study

Abstract

INTRODUCTION: Metabolic bone disease is associated with increased morbidity, mortality, and resultant health care costs. Chronic pancreatitis (CP) has multiple overlapping risk factors and complications (smoking, vitamin D malabsorption, fat maldigestion, alcohol abuse, and chronic inflammation) that promote an imbalance in bone mineralization and remodeling. This, in turn, leads to an increased risk of osteoporosis and fragility fractures. In this pilot study, we sought to assess the distribution of bone mineral density (BMD) and the clinical factors associated with reduced BMD in CP. METHODS: We selected patients with a definitive diagnosis of CP (according to the American Pancreatic Association guidelines) who were enrolled into The Ohio State Wexner Medical Center Pancreas Disease Biobank. Demographic and clinical details were abstracted, including age, sex, race, BMI, smoking, and alcohol history, and compared to BMD assessed by DEXA scans. RESULTS: Sixty-four patients with definite CP were identified. A total of 32 (50%) had bone mineral density screening with DEXA scans completed. Of those with BMD assessment, 59.3% (19/32) had a Z-score < −1.5. The overall mean of the lowest DEXA Z-score for the CP cohort was −1.39. Of the CP patients with metabolic bone disease, the majority were older than 50 years of age (68%), and there was an equal distribution of males (59%) to females (60%). The mean Z-score was lower for females than males, although this did not reach statistical significance (−1.9 versus −1.3 respectively; P = 0.25). There was no association with bone disease and race, smoking and alcohol. CONCLUSION: Despite the increased risk of metabolic bone disease, only 50% of patients with CP had screening DEXA scans. Of these, metabolic bone disease was seen in up to 60% of CP patients. Older patients and female-gender had similar bone mineral density trends in CP as expected in the general population. A larger sample size of CP patients is needed to evaluate the true impact and predictors of metabolic bone disease in CP.