Osteoporosis and sarcopenia are common and insufficiently diagnosed among chronic pancreatitis patients

Parhiala, Mikael; Ukkonen, Mika; Sand, Juhani; Laukkarinen, Johanna

doi:10.1186/s12876-023-02756-w

Cited by 5 publications

(3 citation statements)

References 47 publications

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“…9 Many patients with gastrointestinal diseases, such as inflammatory bowel disease, severe liver disease, and various forms of pancreatitis, frequently undergo abdominal CT or MRI scans that enable psoas muscle mass at the L3 or L4 vertebra level to be calculated. [10][11][12][13] Moreover, it is easier to measure PMA than to measure the area of skeletal muscles. Because MRI requires much more time and is costlier than CT, all patients with AP in the present study underwent CT scanning, with only a few undergoing MRI after CT.…”

Section: Discussionmentioning

confidence: 99%

Cutoff Value of Psoas Muscle Area as Reduced Muscle Mass and Its Association with Acute Pancreatitis in China

Fu¹,

Li²,

Xing³

et al. 2023

IJGM

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Objective The Global Leadership Initiative on Malnutrition (GLIM) has proposed criteria for the diagnosis of malnutrition, one of which is reduced muscle mass. Computed tomography (CT) assessment of psoas muscle area (PMA) has been used to estimate muscle mass in patients, including those with acute pancreatitis (AP). The present study aimed to define the cutoff value of PMA indicative of reduced muscle mass in patients with AP and to assess the impact of reduced muscle mass on the severity and early complications of AP. Methods Clinical data of 269 patients with AP were analyzed retrospectively. The severity of AP was determined according to the revised Atlanta classification. PMA was evaluated by CT and used to calculate the psoas muscle index (PMI). Cutoff values for reduced muscle mass were calculated and validated. Logistic regression analysis was performed to assess the relationship between PMA and the severity of AP. Results PMA was a better indicator of reduced muscle mass than PMI, with cutoff values of 11.50 cm 2 for men and 8.22 cm 2 for women. Rates of local complications, splenic vein thrombosis, and organ failure were significantly higher in AP patients with low than high PMA (all p < 0.05). PMA showed good ability to predict splenic vein thrombosis in women, with an area under the receiver operating characteristic curve of 0.848 (95% confidence interval 0.768–0.909, sensitivity 100%, specificity 83.64%). Multivariate logistic regression revealed that PMA was an independent risk factor for moderately severe plus severe AP (odds ratio 5.639, p = 0.001) and severe AP (odds ratio 3.995, p = 0.038). Conclusion PMA is a good predictor of the severity and complications of AP. The PMA cutoff value is a good indicator of reduced muscle mass.

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Section: Discussionmentioning

confidence: 99%

Cutoff Value of Psoas Muscle Area as Reduced Muscle Mass and Its Association with Acute Pancreatitis in China

Fu¹,

Li²,

Xing³

et al. 2023

IJGM

View full text Add to dashboard Cite

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“…Moreover, an increase in pro-inflammatory cytokines in blood serum (interleukin 1 beta (IL-1β), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNFα)), as well as inflammatory indicators (C-reactive protein (CRP), lactate dehydrogenase (LDH), gamma-glutamyltransferase (GGTP), superoxide dismutase (SOD), and reduced glutathione (GSH)) were observed in the pigs, confirming systemic inflammation [7]. There is a clear association between chronic systemic inflammation and osteoporosis (OP), a systemic bone metabolic disorder characterized by deteriorating bone microarchitecture and increased bone vulnerability [8,9] which contributes to accelerated bone loss and an increased risk of fractures in affected individuals [10,11]. Additionally, osteoporosis may coexist with conditions such as osteoarthritis [12,13], a complex disease that leads to joint pain, reduced joint mobility, and impaired joint function [14,15].…”

Section: Introductionmentioning

confidence: 92%

Does Chronic Pancreatitis in Growing Pigs Lead to Articular Cartilage Degradation and Alterations in Subchondral Bone?

Tomaszewska,

Hułas-Stasiak,

Dobrowolski

et al. 2024

IJMS

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Chronic pancreatitis (CP), a progressive inflammatory disease, poses diagnostic challenges due to its initially asymptomatic nature. While CP’s impact on exocrine and endocrine functions is well-recognized, its potential influence on other body systems, particularly in young individuals, remains underexplored. This study investigates the hypothesis that CP in growing pigs leads to alterations in articular cartilage and subchondral bone, potentially contributing to osteoarthritis (OA) development. Utilizing a pig model of cerulein-induced CP, we examined the structural and compositional changes in subchondral bone, articular cartilage, and synovial fluid. Histological analyses, including Picrosirius Red and Safranin-O staining, were employed alongside immuno-histochemistry and Western blotting techniques. Our findings reveal significant changes in the subchondral bone, including reduced bone volume and alterations in collagen fiber composition. Articular cartilage in CP pigs exhibited decreased proteoglycan content and alterations in key proteins such as MMP-13 and TGF-β1, indicative of early cartilage degradation. These changes suggest a link between CP and musculoskeletal alterations, underscoring the need for further research into CP’s systemic effects. Our study provides foundational insights into the relationship between CP and skeletal health, potentially guiding future pediatric healthcare strategies for early CP diagnosis and management.

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“…osteopenia, osteoporosis) in patients with CP ranged from 36.5% to 57.0%. 22 – 27 The observational study ‘ Prospective Evaluation of Chronic Pancreatitis for Epidemiologic and Translational Studies (PROCEED Study) ’ was completed in 2022. A cross-sectional analysis from the PROCEED study involving 282 patients with CP showed that the prevalence of osteopathy on dual-energy X-ray absorptiometry scan was 56.0%, and higher prevalences of traumatic and spontaneous fracture were observed in the cohort of CP patients with osteopathy.…”

Section: Nutritional Supportmentioning

confidence: 99%

Management of chronic pancreatitis: recent advances and future prospects

Han,

Lv,

2024

Therap Adv Gastroenterol

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As a progressive fibroinflammatory disease, chronic pancreatitis (CP) often manifests as recurrent bouts of abdominal pain with or without complications, causing a heavy burden of health care. In recent years, some meaningful insights into the management of CP have been obtained from randomized controlled trials, systematic reviews, and meta-analyses, which were of great importance. Based on this research, it is shown that there are various treatments for CP. Therefore, it is of great importance to choose a suitable strategy for patients with CP individually. Relevant evidence on the management of CP was summarized in this review, including nutrition supplements, medication, endoscopy, surgery, exploration of novel therapies as well as evaluation and prediction of treatment response.

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Osteoporosis and sarcopenia are common and insufficiently diagnosed among chronic pancreatitis patients

Cited by 5 publications

References 47 publications

Cutoff Value of Psoas Muscle Area as Reduced Muscle Mass and Its Association with Acute Pancreatitis in China

Cutoff Value of Psoas Muscle Area as Reduced Muscle Mass and Its Association with Acute Pancreatitis in China

Does Chronic Pancreatitis in Growing Pigs Lead to Articular Cartilage Degradation and Alterations in Subchondral Bone?

Management of chronic pancreatitis: recent advances and future prospects

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