Abstract

Abstract Introduction Chronic pancreatitis is a progressive fibroinflammatory disease and can lead to irreversible loss of pancreatic function and malnutrition. These, alongside excess alcohol intake, increase the risk of low bone density. Osteoporosis can be debilitating, reduces quality of life, increases fracture risk, and poses significant costs to healthcare. There remains, however, a paucity in current literature evaluating the prevalence of osteoporosis in this population. This meta-analysis evaluates the prevalence of osteoporosis and fractures in chronic pancreatitis. Methods A systematic search of Medline, Embase, CENTRAL, and ClinicalTrials.gov databases was undertaken to identify studies between January 2000 and May 2022. The primary outcome of osteoporosis prevalence and secondary outcomes of osteopenia prevalence and fragility fractures were extracted from the included studies. Where available, a subgroup analysis was performed to compare the likelihood of developing osteoporosis in chronic pancreatitis compared with control. Results Nineteen studies evaluating 2,027,767 participants were included in the analysis (20,463 and 2,007,304 were in the chronic pancreatitis and control groups respectively). The pooled prevalence of osteoporosis was 19% (95% CI 13-26%; I2=94%). Patients with chronic pancreatitis were more likely to have osteoporosis when compared with controls (OR 2.80, 95% CI 1.86-4.21). The prevalence of osteopenia and overall fractures were 37% (95% CI 31-44%; I2=81%) and 14% (95% CI 7-22%; I2= 99%) respectively. Conclusion The prevalence of osteoporosis and osteopenia are considerable in chronic pancreatitis and can also result in fractures. Further population-based studies are required to evaluate the disease burden of osteoporotic fractures and associated mortality in chronic pancreatitis.

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