High Prevalence of Osteopathy in Chronic Pancreatitis: A Cross-sectional Analysis from the PROCEED Study.

INTRODUCTION Chronic pancreatitis (CP) is associated with osteopathy (osteoporosis or osteopenia). However, existing literature is mostly limited to retrospective or administrative studies that have not clearly defined the prevalence and risk factors. Our aim was to identify patient- and disease-related associations with osteopathy in a prospective cohort study of CP. METHODS We studied 282 subjects with definitive CP enrolled in the PROCEED study who had a baseline dual-energy X-ray absorptiometry (DXA) scan. Osteopenia and osteoporosis were defined using the lowest T-scores. Clinical data were collected using standardized case report forms. Comparisons were performed with a multivariate logistic regression model with forward selection to identify risk factors for osteopathy. RESULTS The majority of subjects had osteopathy on DXA scan (56.0%; 17.0% osteoporosis; 39.0% osteopenia). Subjects with osteopathy had a higher prevalence of traumatic (40.0% vs. 26.4%, p=0.02) and spontaneous fractures (3.9% vs. 0, p=0.04). On multivariate analysis, older age (OR 1.29 per 5 years, 95% CI 1.15-1.45), female sex (OR 3.08, 95% CI 1.75-5.43), white race (OR 2.68, 95% CI 1.20-6.01), and underweight BMI category (OR 7.40, 95% CI 1.56-34.99) were associated with higher probability of osteopathy. There were no significant associations between osteopathy and patient and disease-related features of CP. CONCLUSION In the largest study of CP patients who underwent DXA screening, the majority had osteopathy. There are overlapping risk factors with osteopathy in the general population, but the high prevalence in men and younger women supports the need for future investigations into the mechanisms of bone loss in CP. ClinicalTrials.gov number, NCT03099850.