Clin Osteol 2008; 13(1): 17-22

Chronic pancreatitis and metabolic osteopathiesNews

H. Dujsíková, P. Dítě, J. Tomandl, A. Ševčíková, M. Mišejková, M. Pfiecechtělová

Chronic pancreatitis is an inflammatory disease manifested by maldigestion and in an advanced stage by malabsorption. The aim of our research was monitoring the occurrence of metabolic osteopathies (osteopenia, osteoporosis and osteomalacia ) in patients with chronic pancreatitis. The group consisted of 73 patients (17 women a 56 men) in different stage of chronic pancreatitis. In all patients were determined serum concentrations of Ca, P, 25-OH vitamin D, 1,25 (OH)2 vitamin D, alkaline phosphatase and its bone izoen­ zym. Bone mineral density was measured by dual - energy X- ray absorptiometry (DXA) in lumbar spine (L1-L4) and in proximal femur. In cases of low BMD below -1SD, further investigations, including urinary excretion of calcium and phosphate, were perfor­ med in order to rule out another causes of secondary osteopathy. Osteopathy was found in 39.7 % of patients, in particular osteopenia in 65.5 %, osteoporosis in 13.8 %, and osteomalacia in 20.7 %. The contributing factors to metabolic osteopathy in patients with chronic pancreatitis seem to be malabsorption with impaired enterohepatioc circulation of vitamin D, in cases of mild pancreatitis, changes in intestinal flora and vitamin D malabsorption are likely candidates as well.

Keywords: chronic pancreatitis, vitamin D, osteoporosis, osteopeni, osteomalacia

Published: June 11, 2008  Show citation