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Chronic Pancreatitis and Fractures

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – As is seen in certain other gastrointestinal illnesses, the prevalence of low-trauma fractures is higher among patients with chronic pancreatitis than in the general population, according to a new study.

Dr. April S. Tignor, at Brigham and Women’s Hospital, Boston, Massachusetts, and colleagues explain in the American Journal of Gastroenterology online August 24 that screening guidelines are in place for GI diseases that carry a high risk of osteoporosis and low-trauma fracture.

Since chronic pancreatitis is associated with factors that may affect bone and mineral metabolism, the researchers investigated the prevalence of low-trauma fracture in this condition in comparison to other GI disorders.

Using a clinical data registry covering 3.5 million patients in the Partners HealthCare System, which includes Brigham and Women’s Hospital, the authors found that the period prevalence of fractures was 4.82% in chronic pancreatitis, 5.0% with celiac disease, 3.0% for Crohn’s disease, 5.43% with gastrectomy, and 4.83% for cirrhosis. By comparison, the prevalence was 1.13% in a background population of controls.

After adjustment, the odds ratio for fracture with chronic pancreatitis was 2.4 (p<0.0001). “This report is the first published description of fracture prevalence in chronic pancreatitis,” Dr. Tignor and colleagues state. They conclude, “Recognition of a significant rate of fragility fracture in chronic pancreatitis may lead to guidelines regarding management and prevention of metabolic bone disease similar to that of other ‘high-risk’ GI illness patients.” Reference:
High Prevalence of Low-Trauma Fracture in Chronic Pancreatitis

Am J Gastroenterol 2010.