Burden of bone disease in chronic pancreatitis: A systematic review and meta-analysis

doi:10.3748/wjg.v29.i8.1374

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World J Gastroenterol. Feb 28, 2023; 29(8): 1374-1394
Published online Feb 28, 2023. doi: 10.3748/wjg.v29.i8.1374

Table 1 Description of study design and study population

Ref.	Design	CP patients	CP severity, n (%)	CP etiology, n (%)	Study population	Race	Female patients, n (%)	Age, mean ± SD	BMI, mean ± SD
Morán et al[17], 1997	Cross sectional	Clinicoradiological	All severe	Alcohol: 10 (71.4)	CP: 14		CP: 0	CP: 56¹ (-)	CP: 22.64
Morán et al[17], 1997	Cross sectional	Clinicoradiological	All severe	Idiopathic 4 (28.6)	Controls: -		Controls: -	Controls: -	Controls: -
Haaber et al[18], 2000	Cross sectional	Clinicoradiological		Alcohol: 46 (79)	CP: 58	CP: -	CP: 26 (44.8)	CP: 53 (9)	CP: 23 (5)
Haaber et al[18], 2000	Cross sectional	Clinicoradiological		Alcohol: 46 (79)	Controls: -	Controls: -	Controls: -	Controls: -	Controls: -
Dujsikova et al[19], 2008	Cross sectional	EUS based criteria	Wiersema classification: Mild: 41 (56.2), moderate: 12 (16.4), severe: 20 (27.4)		CP: 73	CP: -	CP:17 (23.28)	CP: 46.61 (13.23)	CP: -
Dujsikova et al[19], 2008	Cross sectional	EUS based criteria			Controls: -	Controls: -	Controls: -	Controls: -	Controls: -
Tignor et al[20], 2010	Retrospective cohort	ICD-9 code 577.1			CP: 3192	CP: White: 2091 (65.5), black: 419 (13.1), hispanic: 222 (6.9), others: 532 (16.7)	CP: 1636 (51.25)	CP: -	CP: -
Tignor et al[20], 2010	Retrospective cohort	ICD-9 code 577.1			Controls: 1436699	Control: White: 860190 (59.9), black: 115199 (8.0), hispanic: 102000, other: 451110	Controls: 907328 (63.15)	Controls: -	Controls: -
Sudeep et al[22], 2011	Cross sectional	Not defined		Tropical pancreatitis: 20 (65)	CP: 31	CP: -	CP: 0	CP: 35.8 (9)	CP: 18.46 (2.86)
Sudeep et al[22], 2011	Cross sectional	Not defined		Idiopathic: 11 (35)	Controls: 35	Controls: -	Controls: 0	Controls: 38.6 (5.2)	Controls: 22.6 (3.1)
Joshi et al[21], 2011	Cross sectional	Clinicoradiological		All patients with tropical calcific pancreatitis	CP: 72	CP: -	CP: 34 (47.2)	CP: 31.1 (10.3)	CP: 19 (3.1)
Joshi et al[21], 2011	Cross sectional	Clinicoradiological		All patients with tropical calcific pancreatitis	Controls: 100	Controls: -	Controls: 50 (50)	Controls: 32.6 (9.6)	Controls: 23.6 (3.2)
Duggan et al[23], 2012	Cross sectional	Clinicoradiological	Cambridge classification: Mild (37.1), severe (27.4)	Alcohol: 24 (38.7)	CP: 62	CP: -	CP: 17 (27.41)	CP: 47.9 (12.5)	CP: 25.6 (5)
Duggan et al[23], 2012	Cross sectional	Clinicoradiological	Cambridge classification: Mild (37.1), severe (27.4)	Idiopathic: 38 (61.3)	Controls: 66	Controls: -	Controls: 18 (27.27)	Controls: 47.74 (11)	Controls: 28.0 (4.1)
Sikkens et al[25], 2013	Prospective cohort	Clinicoradiological		Alcohol: 20 (50)	CP: 40	CP: -	CP: 17 (42.5)	CP: 52 (11)	CP: 24 (5)
				Idiopathic: 17 (43)	Controls: -	Controls: -	Controls: -	Controls: -	Controls: -
				Other: 3 (7)
Prabhakaran et al[28], 2014	Cross sectional	Clinicoradiological.	Cambridge classification: Mild (13.1), moderate (5.05), marked: (81.8)	Alcohol: 72 (70)	CP: 103	CP: -	CP: 0	CP: 38.6 (20.64)	CP: 19.7
Prabhakaran et al[28], 2014	Cross sectional	Clinicoradiological.		Idiopathic: 31 (29.1)	Controls: -	Controls: -	Controls: 0	Controls: 36.7 (20.70)	Controls: -
Bang et al[26], 2014	Prospective cohort	ICD-10: K86.0 (alcohol induced CP), K86.1 (other CP)			CP: 11972	CP: -	CP: 4011 (33.5)	CP: 54.5 (14)	CP: -
Bang et al[26], 2014	Prospective cohort	ICD-10: K86.0 (alcohol induced CP), K86.1 (other CP)			Controls: 119720	Controls: -	Controls: 40106 (33.49)	Controls: 54.5 (14)	Controls: -
Duggan et al[27], 2015	Cross sectional	Clinicoradiological	Cambridge classification (unspecified number in each category)	Alcohol: 18 (62.1)	CP: 29	CP: -	CP: 12 (41.37)	CP: 44.3 (12.3)	CP: 25.2 (5.1)
				Idiopathic: 8 (27.6)	Controls: 29	Controls: -	Controls: 12 (41.37)	Controls: 45.8 (9.8)	Controls: 27.3 (3.7)
				Other: 3 (10.3)
Munigala et al[24], 2016	Cross sectional	ICD-9 code 577.1			CP: 3257	CP: White 2120 (65), black 1012 (31), others 125 (4)	CP: 178 (5.46)	CP: 54.2 (11.1)	CP: -
Munigala et al[24], 2016	Cross sectional	ICD-9 code 577.1			Controls: 450655	Controls: White: 325132 (72), black: 76031 (17), others: 49492 (11)	Controls: 53108 (11.78)	Controls: 53.6 (13.9)	Controls: -
Kumar et al[29], 2017	Cross sectional	Clinicoradiological			CP: 102	CP: -	CP: 17 (16.7)	CP: 40.8 (12.6)	CP: 22.5 (3.2)
Kumar et al[29], 2017	Cross sectional	Clinicoradiological			Controls: -	Controls: -	Controls: -	Controls: -	Controls: -
Stigliano et al[32], 2018	Cross sectional	M-ANNHEIM criteria	M-ANNHEIM scoring system: Minor: 74 (35), Increased: 99 (47), advanced: 32 (15), marked: 6 (3)	Alcoholic: 91 (43)	CP: 211	CP: -	CP: 69 (32.7)	CP: 60 (-)	CP: 24 (4)
				Idiopathic: 40 (19)	Controls: -	Controls: -	Controls: -	Controls: -	Controls: -
				Hereditary: 8 (4)
				Obstructive: 12 (5.7)
Kuhlmann et al[30], 2018	Cross sectional	Score ≥ 4 points based on Lüneburg criteria			CP: 67	CP: -	CP: 27 (40.29)	CP: 60¹ (-)	CP: 22.7 (15-37.9)
Kuhlmann et al[30], 2018	Cross sectional	Score ≥ 4 points based on Lüneburg criteria			Controls: -	Controls: -	Controls: -	Controls: -	Controls: -
Min et al[31], 2018	Prospective cohort	EUS criteria and/or	EUS criteria (unspecified number in each category)	Toxic/metabolic: 54 (59.3)	CP: 91	CP: -	CP: 34 (37.36)	CP: 48.6 (10.4)	CP: 26.1 (7.8)
		secretin stimulation testing		Idiopathic: 17 (18.6)	Controls: -	Controls: -	Controls: -	Controls: -	Controls: -
				Hereditary: 13 (14.3)
				Autoimmune: 5 (5.5)
Gupta et al[33], 2019	Prospective cohort	Clinicoradiological and EUS			CP: 38	CP: White 35 (92), black 3 (8)	CP: 19 (50)	CP: 44 (10.7)	CP: 26.7 (5.9)
Gupta et al[33], 2019	Prospective cohort	Clinicoradiological and EUS			Controls: -	Controls: -	Controls: -	Controls: -	Controls: -
Kanakis et al[7], 2020	Retrospective cohort	Clinicoradiological			CP: 239	CP: White 43 (88), minorities: 6 (12)	CP: 37 (15.48)	CP: 56¹ (-)	CP: 23 (8)
Kanakis et al[7], 2020	Retrospective cohort	Clinicoradiological			Controls: -	Controls: -	Controls: -	Controls: -	Controls: -
Hart et al[34], 2021	Cross sectional	Clinicoradiological	Cambridge classification (unspecified number in each category)	-	CP: 282	CP: White race (87.2), minorities (12.8)	CP: 145 (51.41)	CP: 56¹ (-)	CP: -
Hart et al[34], 2021	Cross sectional	Clinicoradiological		-	Controls: -	Controls: -	Controls: -	Controls: -	Controls: -
Vujasinovic et al[8], 2021	Retrospective cohort	2002 Asia-Pacifc consensus report		Alcohol and smoking: 40 (33.9)	CP: 118	CP: -	CP: 49 (41.52)	CP: 53.1 (16.3)	CP: 23.9 (4.4)
				Smoking only: 12 (11)	Controls: -	Controls: -	Controls: -	Controls: -	Controls: -
				Alcohol only: 7 (5.9)
				Hereditary: 21 (11.8)
				Immunological: 23 (14.4)
				Efferent duct factors: 11 (9.3)
Tang et al[35], 2021	Cross sectional	ICD-9 based codes	M-ANNHEIM clinical stage 0: 6 (5.8), I: 59 (56.7), II: 26 (25.0), III: 8 (7.7), IV: 5 (4.8)		CP: 104	CP: -	CP: 31 (29.8)	CP: 46.08 (14.43)	CP: 21.43 (2.85)
Tang et al[35], 2021	Cross sectional	ICD-9 based codes			Controls: -	Controls: -	Controls: -	Controls: -	Controls: -

¹Number of subjects who consented to Dual-energy X-ray Absorptiometry scan if detailed in the studies

CP: Chronic pancreatitis; BMI: Body mass index; EUS: Endoscopic ultrasound; ICD: International Classification of Diseases.

Citation: Chhoda A, Hernandez-Woodbine MJ, Addo NAA, Nasir SA, Grimshaw A, Gunderson C, Ahmed A, Freedman SD, Sheth SG. Burden of bone disease in chronic pancreatitis: A systematic review and meta-analysis. World J Gastroenterol 2023; 29(8): 1374-1394
URL: https://www.wjgnet.com/1007-9327/full/v29/i8/1374.htm
DOI: https://dx.doi.org/10.3748/wjg.v29.i8.1374