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Increased risk of fractures among patients with cirrhosis or chronic pancreatitis

This month's Clinical Gastroenterology & Hepatology reports and increased risk of fractures among patients with cirrhosis or chronic pancreatitis.

News image

Cirrhosis and chronic pancreatitis are accompanied by inflammation and malnutrition.

Both conditions can have negative effects on bone metabolism and promote fractures.

Dr Ulrich Christian Bang and colleagues evaluated the risk of fractures among patients with chronic pancreatitis or cirrhosis and determined the effect of fat malabsorption on fracture risk among patients with chronic pancreatitis.

The researchers performed a retrospective cohort study using the Danish National Patient Register to identify patients diagnosed with chronic pancreatitis or cirrhosis.

The team analyzed data collected from 1995 to 2010, on 20,769 patients.

Each patient was compared with 10 age- and sex-matched controls.

Local recurrence occurred in 5 cases in the EMR group
Clinical Gastroenterology & Hepatology

The researchers also assessed the risk of fractures among patients with chronic pancreatitis who received pancreatic enzyme substitution (PES) for fat malabsorption.

During the study period, bone fractures occurred in 3954 patients with cirrhosis, and 2594 patients with chronic pancreatitis.

The adjusted hazard ratio (HR) for any fracture was 2.4 in patients with cirrhosis, and 1.7 in patients with chronic pancreatitis.

The relative risk of low-trauma fractures was highest among individuals younger than 50 years old.

The team observed that alcohol as an etiology was associated with an increased risk of fracture compared with patients with nonalcoholic cirrhosis, and chronic pancreatitis.

Patients with chronic pancreatitis receiving PES for fat malabsorption had a lower risk of fractures than other chronic pancreatitis patients.

However, increasing the duration of treatment with PES was associated with an increased risk of fracture.

Dr Bang's team concludes, "Patients, especially younger patients, with cirrhosis or chronic pancreatitis have an increased risk of fractures of all types."

Clin Gastroenterol Hepatol 2014: 12(2): 320-326
14 February 2014

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