Prabhakaran Anusree, Bhasin Deepak K, Rana Surinder S, Bhadada Sanjay K, Bhansali Anil, Rao Chalapathi, Gupta Rajesh, Khandelwal Niranjan
Trop Gastroenterol. 2014 Apr-Jun;35(2):107-12. doi: 10.7869/tg.189.
There is limited information on the bone mineral metabolism in patients with chronic pancreatitis (CP).
103 patients with CP (all males: mean age 38.6 ± 20.64 yrs) and 40 age matched control males (mean age: 36.7 ± 20.70 yrs) were prospectively studied. Serum levels of 25 (OH) Vitamin D3, alkaline phosphatase (ALP), and parathyroid hormone (PTH) were measured. Bone mineral density (BMD) was measured using adual-energy X-ray absorptiometry (DEXA) scanner.
Seventy two (70%) patients had alcohol related chronic pancreatitis (ACP), 30 (29.1%) patients had idiopathic chronic pancreatitis (ICP) and one patient had post-traumatic chronic pancreatitis. Fifty nine (59.8%) patients had chronic calcific pancreatitis (CCP) and 39 (37.8%) patients were diabetic. Steatorrhea was noted in 21 (20.4%) patients. On comparison with controls, patients with chronic pancreatitis had significantly lower 25 (OH) Vitamin D3 levels (p = 0.01). On evaluation of bone mineral density (BMD) at lumbar spine, 46% patients were osteopenic and 12% patients were osteoporotic. On evaluation of BMD of femur, 30.1% patients were osteoporotic and 39.8% patients were osteopenic. No significant difference was found in the frequency of metabolic osteopathy between alcoholic and idiopathic groups (p = 0.108), calcific and non-calcific groups (p = 0.410), diabetic and non-diabetic groups (p = 0.126). smokers and non-smokers (p = 0.198), and patients with and without history of steatorrhea (p = 0.265) and indifferent severity groups ofupancreatitis (p = 0.910) CONCLUSIONS: Majority of patients with both ACP and ICP had low BMD and similar frequency of bone changes between various groups suggests that systemic inflammation may play an important role in its pathogenesis. Further detailed metabolic studies are necssary to define the pathogenic mechanism of metabolic osteopathy associated with chronic pancreatitis.
关于慢性胰腺炎（CP）患者骨矿物质代谢的信息有限。
前瞻性研究了103例CP患者（均为男性，平均年龄38.6±20.64岁）和40例年龄匹配的对照男性（平均年龄：36.7±20.70岁）。测量血清25（OH）维生素D3、碱性磷酸酶（ALP）和甲状旁腺激素（PTH）水平。使用双能X线吸收法（DEXA）扫描仪测量骨密度（BMD）。
72例（70%）患者患有酒精性慢性胰腺炎（ACP），30例（29.1%）患者患有特发性慢性胰腺炎（ICP），1例患者患有创伤后慢性胰腺炎。59例（59.8%）患者患有慢性钙化性胰腺炎（CCP），39例（37.8%）患者患有糖尿病。21例（20.4%）患者出现脂肪泻。与对照组相比，慢性胰腺炎患者的25（OH）维生素D3水平显著降低（p = 0.01）。评估腰椎骨密度（BMD）时，46%的患者骨质减少，12%的患者骨质疏松。评估股骨BMD时，30.1%的患者骨质疏松，39.8%的患者骨质减少。酒精性和特发性组之间（p = 0.108）、钙化性和非钙化性组之间（p = 0.410）、糖尿病和非糖尿病组之间（p = 0.126）、吸烟者和非吸烟者之间（p = 0.198）以及有和无脂肪泻病史的患者之间（p = 0.265）以及不同严重程度的胰腺炎组之间（p = 0.910）代谢性骨病的发生率均无显著差异。结论：大多数ACP和ICP患者骨密度较低，不同组之间骨改变的频率相似，提示全身炎症可能在其发病机制中起重要作用。需要进一步详细的代谢研究来确定与慢性胰腺炎相关的代谢性骨病的发病机制。
