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Chronic Pancreatitis associated with painful bones (vitamin D) – meta-analysis July 2013

High Prevalence of Osteoporosis in Patients with Chronic Pancreatitis: a Systematic Review and Meta-Analysis

Clinical Gastroenterology and Hepatology
Sinead N. Duggan siduggan at tcd.ie, Niamh D. Smyth. Anne Murphy. David MacNaughton , Stephen JD. O’Keefe , Kevin C. Conlon
Received 21 March 2013; received in revised form 19 June 2013; accepted 19 June 2013. published online 15 July 2013.

Background & Aims: Patients with chronic pancreatitis may be at high risk for osteoporosis and osteopenia. We performed a systematic review and meta-analysis to determine the prevalence of osteoporosis and osteopenia in patients with chronic pancreatitis.

Methods: We performed a systematic review and meta-analysis of observational studies that reported prevalence rates of osteoporosis and osteopenia. Articles were identified from MEDLINE, EMBASE, and SCOPUS databases (through October 2012) and a manual search of the literature. The primary outcome measure was bone density, measured by dual-energy X-ray absorptiometry (T-score or Z-score). When available, data on the prevalence of osteopenia, bone mineral density, and bone mineral content were also recorded.
Results

Ten studies including 513 patients were eligible for inclusion. Based on a random effects model, the pooled prevalence rate for osteoporosis among patients with chronic pancreatitis was 23.4% (95% confidence interval 16.6, 32.0). The pooled prevalence for osteopenia was 39.8% (95% confidence interval 29.1, 51.6). The pooled prevalence rate for either osteoporosis or osteopenia was 65% (95% confidence interval 54.7-74.0).
Conclusions

Based on meta-analysis, almost 1 of 4 patients with chronic pancreatitis have osteoporosis, and almost two thirds have either osteoporosis or osteopenia. Osteoporosis and osteopenia are under-appreciated sources of morbidity in patients with chronic pancreatitis. Bone health management guidelines are urgently required in patients with chronic pancreatitis.

Abbreviations: BMC, bone mineral content, BMD, bone mineral density, BMI, body mass index, DXA, Dual-energy X-ray absorptiometry, MOOSE, Meta-analysis of Observational Studies in Epidemiology, NOS, Newcastle-Ottawa Scale, PEI, pancreatic exocrine insufficiency, PERT, pancreatic enzyme replacement therapy


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