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Risk of osteopaenia, osteoporosis and osteoporotic fractures in patients with chronic pancreatitis: A systematic review and meta-analysis

Koh, Amanda; Oyende, Olamide; Humes, David J.; Lobo, Dileep N.

Risk of osteopaenia, osteoporosis and osteoporotic fractures in patients with chronic pancreatitis: A systematic review and meta-analysis Thumbnail


Authors

Amanda Koh

Olamide Oyende

DAVID HUMES david.humes@nottingham.ac.uk
Clinical Associate Professor

DILEEP LOBO dileep.lobo@nottingham.ac.uk
Professor of Gastrointestinal Surgery



Abstract

Background & aims: Chronic pancreatitis results in irreversible pancreatic dysfunction and malnutrition which, alongside excess alcohol intake, can increase the risk of low bone density. Osteoporosis increases the risk of fractures and chronic bone pain, reduces quality of life, and poses considerable costs to healthcare. Despite this, there remains a paucity of literature evaluating bone health in this patient population. This systematic review and meta-analysis evaluated the prevalences of osteopaenia, osteoporosis and fractures in patients with chronic pancreatitis. Methods: A comprehensive search of Medline, Embase, ClinicalTrials.gov, and CENTRAL databases was undertaken to identify eligible studies from January 2000 to May 2022. The prevalences of osteopenia, osteoporosis and fragility fractures were extracted from the included studies. Where available, a subgroup analysis was performed to compare the likelihood of developing osteoporosis in patients with chronic pancreatitis compared with control. Results: Nineteen studies reporting on 2,027,764 participants (20,460 with chronic pancreatitis and 2,007,304 controls) were included. The pooled prevalence of osteoporosis was 19% (95% CI 13 to 26%; I2 = 94%). Patients with chronic pancreatitis were more likely to have osteoporosis when compared with those in the control group (OR 2.80, 95% CI 1.86 to 4.21; I2 = 21%). The prevalences of osteopaenia and fractures in patients with chronic pancreatitis were 37% (95% CI 31 to 44%; I2 = 81%) and 14% (95% CI 7 to 22%; I2 = 99%) respectively. Conclusion: The prevalences of osteopenia and osteoporosis are significant in patients with chronic pancreatitis and can increase the risk of developing fractures. Further population-based studies are required to evaluate the disease burden of osteoporotic fractures and associated morbidity and mortality in chronic pancreatitis.

Citation

Koh, A., Oyende, O., Humes, D. J., & Lobo, D. N. (2023). Risk of osteopaenia, osteoporosis and osteoporotic fractures in patients with chronic pancreatitis: A systematic review and meta-analysis. Clinical Nutrition, 42(7), 1086-1094. https://doi.org/10.1016/j.clnu.2023.05.019

Journal Article Type Article
Acceptance Date May 25, 2023
Online Publication Date May 27, 2023
Publication Date Jul 1, 2023
Deposit Date May 31, 2023
Publicly Available Date May 31, 2023
Journal Clinical Nutrition
Print ISSN 0261-5614
Electronic ISSN 1532-1983
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 42
Issue 7
Pages 1086-1094
DOI https://doi.org/10.1016/j.clnu.2023.05.019
Keywords bone mineral density; chronic pancreatitis; fractures; osteopaenia; osteoporosis; systematic review
Public URL https://nottingham-repository.worktribe.com/output/21369221
Publisher URL https://www.sciencedirect.com/science/article/pii/S0261561423001619

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