Abstract
INTRODUCTION& Aims: Individuals with chronic pancreatitis are at increased risk for nutritional complications during their clinical course. We appraised the literature to provide updated estimates of the prevalence and predictors of osteoporosis, osteopenia, and osteopathy in chronic pancreatitis using a systematic review and meta-analysis. METHODSSearch strategies were developed for major databases from inception through October 2021. Outcomes of interest included rates of osteopenia and osteoporosis based on DXA scan as well as risk factors. A random effects model was used for analysis and results were expressed as pooled cumulative rates along with 95% confidence interval (CI). RESULTSFrom an initial total of 1704 identified articles, we ultimately selected 17 studies which involved 1,659 subjects (n=1067 men) with chronic pancreatitis. The pooled rate of osteopathy was 58% (95% Confidence Interval (CI): 49% - 67%; P <0.001; I2 = 91.8%). The pooled rate of osteoporosis was 18% (95% CI: 12% - 23%; P <0.001; I2 = 86.3%), while the pooled rates of osteopenia was 39% (95% CI: 31% - 48%; P <0.001; I2 = 91.53%). In the systematic review, factors associated with decreased bone mineral density included smoking, alcohol consumption, older age, female sex, low BMI, and decreased vitamins D and K and fecal elastase levels. CONCLUSIONPatients with chronic pancreatitis have high rates of osteopathy when assessed with DXA imaging. Additional studies with longitudinal follow-up are needed to understand the observed heterogeneity, the cumulative burden of disease, and rate of bone loss in CP.