Preface

Kudo, Masatoshi; Yamao, Kenji; Shimosegawa, Tooru

doi:10.1159/000323476

Cited by 1 publication

(3 citation statements)

References 18 publications

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“…The present findings of no correlation between vitamin D levels and osteopathy are not surprising, and result in accordance with the majority of the previous studies on this topic 8 , 18 , 19 . Similarly, a relation between faecal elastase levels and BMD has been reported in some previous studies 11 , 19 , 22 , 24 , but not in others 8 , 17 , 21 . This might be due to impaired micronutrient absorption being only one of several factors leading to osteopathy in CP patients, and to most cases with PEI receiving PERT.…”

Section: Discussionsupporting

confidence: 57%

“…Osteoporosis is common in CP patients, but the reported prevalence is heterogeneous, ranging from 5% to 39% 8 , 10 , 11 , 17 – 24 , with a pooled rate of 23% in a meta-analysis 12 . Nevertheless, previous studies are limited by the small sample size and the lack of a consistent definition of criteria for CP diagnosis and of assessment of severity and PEI.…”

Section: Discussionmentioning

confidence: 98%

“…However, the pathogenesis of bone density alterations in CP patients is not well established as previous studies carry several limitations. First, most studies had a very small sample size (the largest including 100 patients); moreover, different and heterogeneous nutritional parameters were evaluated and pancreatic exocrine insufficiency (PEI) or severity of the disease were not consistently defined 8 , 10 , 11 , 17 – 24 . No clear correlation between pancreatic function, disease severity, nutritional parameters and lifestyle factors were found 8 , 10 , 11 , 17 – 24 .…”

Section: Introductionmentioning

confidence: 99%

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Vitamins D and K as Factors Associated with Osteopathy in Chronic Pancreatitis: A Prospective Multicentre Study (P-BONE Study)

Stigliano

Waldthaler

Martínez-Moneo

et al. 2018

Clinical and Translational Gastroenterology

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BackgroundOsteopathy is common in patients with chronic pancreatitis (CP), but previous studies carry several limitations. Vitamin K is essential for bone metabolism, but its role in this setting has never been investigated. Our aim is to assess the prevalence of osteoporosis and osteopenia in CP patients, and to investigate the association between osteopathy and CP features and nutritional parameters, especially vitamin D and K levels.MethodsMulticentre cross-sectional study on CP patients diagnosed according to M-ANNHEIM criteria. Bone density was evaluated by dual-energy X-ray absorptiometry and pancreatic function by faecal elastase. Nutritional evaluation included vitamin D and vitamin K. Differences between patients with or without osteopathy were evaluated. The association between investigated variables and bone density were analysed with logistic regression analysis.ResultsIn total, 211 CP patients were enrolled at eight Centres (67% men; mean age 60). In total, 18% had advanced-marked CP, 56% suffered from pancreatic exocrine insufficiency and disease aetiology was alcoholic in 43%. Vitamin D and K were deficient in 56% and 32%, respectively. Osteopenia was diagnosed in 42% and osteoporosis in 22%. In the multivariate analysis, female sex (OR 2.78), age (OR 1.07 per year) and higher BMI (OR 0.84) were associated with the presence of osteoporosis. In male patients, the only factor associated with osteoporosis was vitamin K deficiency (OR 4.23).ConclusionThe present data confirm a high rate of osteopathy in CP patients and highlight the relevance of vitamin K deficiency as only factor associated with osteoporosis in male patients for the first time.

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