Systematic Reviews
Copyright ©The Author(s) 2023.
World J Gastroenterol. Feb 28, 2023; 29(8): 1374-1394
Published online Feb 28, 2023. doi: 10.3748/wjg.v29.i8.1374
Table 3 Characteristics of various covariates and their association with outcome measures
Ref.
PERT use, n (%)
Inflammatory markers: CRP/IL-6, mean ± SD
Vitamin D deficiency, n (%)
Serum PTH, mean ± SD
Alcohol exposure, n (%)
Smokers, n (%)
Diabetes, n (%)
Nutritional parameters
Relevant covariates findings
Morán et al[17], 1997CP: 4 (28.57)CP: -CP: 7 (50)CP: -CP: 0CP: -CP: -Mean serum albumin 3.8 g/dL, 4 (28.6) had BMI < 20. Non-significant associations between osteopathy and BMINon-significant associations between osteopathy and (1) CP severity (as per fecal fat or bicarbonate secretion assessments); (2) CP etiology; (3) Age; and (4) Vitamin D, PTH or calcium
Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -
Haaber et al[18], 2000CP: 26 (44.82)CP: -CP: -CP: 401 (31)CP: -CP: -CP: -Non-significant associations between osteopathy and (1) Duration of CP; and (2) Vitamin D and PTH
Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -
Dujsikova et al[19], 2008CP: -CP: -CP: 63 (86.3)CP: -CP: 8 (10.95)CP: -CP: -Non-significant associations between osteopathy and severity of disease
Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -
Tignor et al[20], 2010CP: -CP: -CP: -CP: -CP: -CP: -CP: -No descriptions of regression analysis or covariate adjustment
Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -
Sudeep et al[22], 2011CP: -CP: -CP: 16 (51.6)CP: -CP: -CP: -CP: -BMI correlated significantly with BMC (r = 0.426; P = 0.017). There was an inverse correlation between stool fat and BMC (r = -0.47; P = 0.03)Non-significant associations between osteopathy and (1) EPI (as per 72-hour fecal fat); and (2) Vitamin D
Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -
Joshi et al[21], 2011CP: 33 (45.83)CP: CRP < 0.32 (-)CP: 62 (86.11)CP: 43.381 (-)CP: -CP: 7 (9.7)CP: 52 (72.2)Lumbar Z score was associated with BMI (beta: 0.276; P = 0.04), serum albumin was significantly lower in patients compared with controls [4.0 (0.6) vs 4.6 (0.7) g/dL, P < 0.001]
Controls: -Controls: CRP < 0.32 (-)Controls: 85 (85)Controls: 84.871 (-)Controls: -Controls: -Controls: -
Significant association of Lumbar Z score with log vitamin D (beta: 0.274; P = 0.04)
Duggan et al[23], 2012CP: -CP: -CP: -CP: -CP: 58 (93.5)CP: 46 (74.19)CP: -BMI < 20: low BMD: 15 (23.8) vs normal BMD 10 (1.1)Higher T scores for the lowest age tertile (P = 0.003). Lower T-score for smokers (P = 0.002). Non-significant associations between T scores at any area and (1) CP severity; (2) EPI; and (3) Ssex
Controls: -Controls: -Controls: -Controls: -Controls: 62 (93.9)Controls: 40 (60.6)Controls: -
Sikkens et al[25], 2013CP: 19 (47.5)CP: -CP: -CP: -CP: 1 (2.5)CP: 27 (67.5)CP: -A high BMI is predictive of a ‘‘higher’’ lowest T-score [Coeff: 0.58 (0.2); P = 0.003]Significant association between osteopathy and untreated EPI (P = 0.013)
Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -
Prabhakaran et al[28], 2014CP: -CP: -CP: 20 (19.41)CP: 27.6 (39.8)CP: 72 (69.9)CP: -CP: 39 (37.86)-Non-significant associations between osteopathy and (1) EPI (as per steatorrhea assessment); (2) CP severity; and (3) CP etiology
Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -
Non-significant associations between osteopathy and vitamin D, PTH and alkaline phosphatase
Bang et al[26], 2014CP: 3545 (29.61)CP: -CP: -CP: -CP: 3651 (30.49)CP: -CP: -Increased risk of fracture among smokers (HR, 1.8; 95%CI, 1.7-1.8) and alcohol related CP (HR, 2.0 vs 1.5; P < 0.0001)
Controls: -Controls: -Controls: -Controls: -Controls: 2753 (2.29)Controls: -Controls: -
Reduced fracture risk among PERT treated CP patients (HR, 0.8; 95%CI, 0.7-0.9)
Duggan et al[27], 2015CP: -CP: CRP: 3.15 (-), IL-6: 5.61 (-)CP: 20CP: 47.1 (19.4) CP: 27 (93.10)CP: 23 (79.3)CP: -Lower T scores were associated with BMI (P = 0.04)Lower T scores were associated with age (P = 0.006). Non-significant association with carboxy-terminal telopeptide of type I collagen; osteocalcin; Procollagen 1 amino-terminal propeptide
Controls: -Controls: CRP: 0.9 (-), IL-6: 3.58 (1.82)Controls: 18Controls: 46.3 (14)Controls: 28 (96.55)Controls: 10 (34.4)Controls: -
Non-significant association with IL-6 and CRPLower T scores were associated with serum vitamin D (P = 0.002). No association with PTH
Munigala et al[24], 2016CP: -CP: -CP: -CP: -CP: 494 (15.16)CP: 505 (15.5)CP: -A significant association of BMD in the columnar spine with vitamin D level (coefficient 0.13 g/cm2; P = 0.017) and BMI (coefficient 0.14 g/cm2; P = 0.007) were observed on univariate analysisIncreased fracture risk among males (adjusted OR, 1.73% (95%CI: 1.46%-2.05%); P < 0.0001), alcohol consumers (OR, 2.30), and smokers (OR, 1.97). Non-significant associations between osteopathy and age
Controls: -Controls: -Controls: -Controls: -Controls: 37146 (8.24)Controls: 77926 (17.29)Controls: -
Kumar et al[29], 2017CP: -CP: -CP: 69 (67.64)CP: -CP: -CP: -CP: 54 (52.94)A MUST score (malnutrition score) of 1 or higher was associated with an increased risk for osteopenia and osteoporosis on Fisher’s exact test (P = 0.0037)Non-significant association between osteopathy and duration of CP
Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -
Non-significant association between osteopathy and vitamin D
Stigliano et al[32], 2018CP: 116 (54.97)CP: -CP: 119 (56.39)CP: -CP: 127 (60.18)CP: 145 (68.72)CP: 77 (36.49)Observed significant association of BMI with osteopathy (OR 0.89; 95%CI: 0.83-0.96; P = 0.003) Osteopathy more prevalent with increasing age (OR 1.06; P = 0.0002), female sex (OR: 3.44; P = 0.0005). Non-significant association between osteopathy and (1) CP severity; (2) EPI (as assessed by fecal elastase); (3) Smoking; (4) Duration of CP; and (5) Alcohol exposure
Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -
Non-significant association between osteopathy and PERT usageNon-significant association between osteopathy and IL-6/CRPNon-significant association between osteopathy, vitamin D and PTH
Kuhlmann et al[30], 2018CP: 28 (41.79)CP: -CP: -CP: -CP: 42 (62.68)CP: 42 (62.68)CP: 22 (32.83)The underweight BMI category, had significant higher odds of osteopathy (OR: 7.40; 95%CI: 1.56-34.99; P < 0.001)Lower Z scores associated with (1) EPI (P = 0.01); (2) Smoking (P = 0.02). Non-significant association with alcohol exposure
Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -
Lower Z scores associated with vitamin D (P = < 0.001)
Min et al[31], 2018CP: -CP: -CP: -CP: -CP: -CP: -CP: -Non-significant association with BMINon-significant association with (1) CP severity; (2) PERT usage
Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -
Gupta et al[33], 2019CP: -CP: -CP: -CP: -CP: 13 (34.21)CP: 18 (47.36)CP: 12 (31.57)Low bone mass was associated with lower BMI. Non-significant association with CP duration
Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -
Kanakis et al[7], 2020CP: -CP: -CP: -CP: -CP: 130 (54.39)CP: 132 (55.23)CP: -For patients, there was no association between total hip BMD and BMI (P = 0.753)No descriptions of regression analysis or covariate adjustment
Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -
Hart et al[34], 2021CP: 161 (57.09)CP: -CP: -CP: -CP: -CP: 191 (67.7)CP: 111 (39.36)Higher osteopathy risk associated with low BMI (P ≤ 0.001)Increased risk of osteopathy with white race (P = 0.017), age (P ≤ 0.001), female sex (P ≤ 0.01) and past or present smoking (P ≤ 0.01). No associations with (1) CP severity (per atrophy assessment); and (2) Duration of CP
Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -
Reduced osteopathy among PERT users (P = 0.02)
Vujasinovic et al[8], 2021CP: 104 (88.13)CP: -CP: -CP: -CP: 53 (44.91)CP: 76 (64.4)CP: 28 (23.72)
Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -
Reduced time to first fracture in PERT-treated patients
Tang et al[35], 2021CP: 51CP: CRP: 0.75 (-), IL-6: 4.51 (-)CP: 76 (73.07)CP: 40.86 (-)CP: 52 (50)CP: 45 (43.26)CP: 28 (26.92)Independent predictors of osteopathy: BMI (OR, 0.72; 95%CI, 0.58-0.89; P = 0.003)Non-significant association between osteopathy and (1) Age; and (2) Duration of CP
Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -Controls: -
Non-significant association between osteopathy and IL-6/CRPNon-significant association between osteopathy and PTH
1Number of subjects who consented to Dual-energy X-ray Absorptiometry scan if detailed in the studies.
CP: Chronic pancreatitis; EPI: Exocrine pancreatic insufficiency; PTH: Parathyroid; PERT: Pancreatic enzyme replacement; BMI: Body mass index; CRP: C-reactive protein; IL-6: Interleukin 6.