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©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
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 | |
| 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) | |
| 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: - | |
| 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: - | ||
| 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) | |
| 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) | |
| 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) |
| 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 |
| 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: - | ||
| 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: - | ||
| 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) | ||
| 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) | ||
| 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) | ||
| 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) | ||
| 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: - |
| 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) | |
| Controls: - | Controls: - | Controls: - | Controls: - | Controls: - |
Table 2 Characteristics of study outcomes, n (%)
| Ref. | Population | Outcome definition | Osteoporosis | Osteopenia | Pathologic fracture |
| Morán et al[17], 1997 | CP: 14 | T score < -2.5 | CP: 3 (21.4) | CP: 10 (71.4) | CP: - |
| Controls: - | T score -1 to -2.5 | Controls: - | Controls: - | Controls: - | |
| Unavailable | |||||
| Haaber et al[18], 2000 | CP: 58 | Z score < -2 | CP: 13 (22.4) | CP: 36 (62) | CP: - |
| Controls: - | Z score < -1.0 | Controls: - | Controls: - | Controls: - | |
| Unavailable | |||||
| Dujsikova et al[19], 2008 | CP: 73 | T score < -2.5 | CP: 4 (5.5) | CP: 19 (26) | CP: 1 (1.3) |
| Controls: - | T score -1 to -2.5 | Controls: - | Controls: - | Controls: - | |
| Undefined | |||||
| Tignor et al[20], 2010 | CP: 3192 | Not studied | CP: - | CP: - | CP: 154 (4.8) |
| Controls: 1436699 | Not studied | Controls: - | Controls: - | Controls: - | |
| Vertebral, hip, and wrist fractures using ICD-9 codes | |||||
| Sudeep et al[22], 2011 | CP: 31 | T score < -2.5 | CP: 9 (29) | CP: - | CP: - |
| Controls: 35 | T score -1 to -2.5 | Controls: 3 (8.5) | Controls: - | Controls: - | |
| Unavailable | |||||
| Joshi et al[21], 2011 | CP: 72 | Z score < -2 | CP: 22 (30.5) | CP: - | CP: 0 |
| Controls: 100 | Unavailable | Controls: - | Controls: - | Controls: - | |
| Undefined | |||||
| Duggan et al[23], 2012 | CP: 62 | T score < -2.5 | CP: 18 (33) | CP: 21 (39.6) | CP: - |
| Controls: 66 | T score -1 to -2.5 | Controls: 6 (10.1) | Controls: 20 (33.8) | Controls: - | |
| Unavailable | |||||
| Sikkens et al[25], 2013 | CP: 40 | T score < -2.5 | CP: 4 (10) | CP: 18 (45) | CP: - |
| Controls: - | T score -1 to -2.5 | Controls: - | Controls: - | Controls: - | |
| Unavailable | |||||
| Prabhakaran et al[28], 2014 | CP: 103 | T score < -2.5 | CP: 25 (30.1) | CP: 38 (45.7) | CP: - |
| Controls: - | T score -1 to -2.5 | Controls: - | Controls: - | Controls: - | |
| Unavailable | |||||
| Bang et al[26], 2014 | CP: 11972 | M80.0-M81.9 based on ICD-10 code | CP: 898 (7.5) | CP: - | CP: 1055 (8.8) |
| Controls: 119720 | Unavailable | Controls: 4070 (3.3) | Controls: - | Controls: 8485 (7) | |
| Spine, humerus, distal forearm, and proximal femur based on ICD-10 codes | |||||
| Duggan et al[27], 2015 | CP: 29 | T score < -2.5 | CP: 9 (31) | CP: 13 (44.8) | CP: - |
| Controls: 29 | T score -1 to -2.5 | Controls: 2 (6.8) | Controls: 15 (51.7) | Controls: - | |
| Unavailable | |||||
| Munigala et al[24], 2016 | CP: 3257 | Unspecified ICD-9 codes | CP: - | CP: - | CP: 153 (4.6) |
| Controls: 450655 | Unavailable | Controls: - | Controls: - | Controls: 9325 (2) | |
| ICD-9 codes: vertebral (805.2, 805.3, 805.4,805.5, 805.6, 805.7), hip (820.0, 820.1, 820.2, 820.3, 820.8, 820.9), or wrist fractures (814.0, 814.1, 813.4, 813.5) | |||||
| Kumar et al[29], 2017 | CP: 102 | Z score < -2 | CP: 6 (5.8) | CP: 21 (20.5) | CP: - |
| Controls: - | Unavailable | Controls: - | Controls: - | Controls: - | |
| Unavailable | |||||
| Stigliano et al[32], 2018 | CP: 211 | T score < -2.5 | CP: 46 (21.8) | CP: 89 (42.1) | CP: 13 (6.1) |
| Controls: - | T score: -1 to -2.5 | Controls: - | Controls: - | Controls: - | |
| Occurring at the spine, hip and distal radius, and not associated with traumatic events | |||||
| Kuhlmann et al[30], 2018 | CP: 67 | T score < -2.5 | CP: 18 (26.8) | CP: 34 (50.7) | CP: - |
| Controls: - | T score: -1 to -2.5 | Controls: - | Controls: - | Controls: - | |
| Unavailable | |||||
| Min et al[31], 2018 | CP: 91 | T score < -2.5 | CP: 10 (22.2) | CP: 21 (46.6) | CP: - |
| Controls: - | T score: -1 to -2.5 | Controls: - | Controls: - | Controls: - | |
| Unavailable | |||||
| Gupta et al[33], 2019 | CP: 38 | T score < -2.5 | CP: 21 (55.2) | CP: - | CP: - |
| Controls: - | T score: -1 to -2.5 | Controls: - | Controls: - | Controls: - | |
| A fall from standing height or less that resulted in a fracture | |||||
| Kanakis et al[7], 2020 | CP: 239 | T score < -2.5 or history of fragility fracture | CP: 15 (30.6) | CP: 27 (55.1) | CP: 22 (9) |
| Controls: - | T score: -1 to -2.5 | Controls: - | Controls: - | Controls: - | |
| Hip or vertebral fracture not due to excess trauma | |||||
| Hart et al[34], 2021 | CP: 282 | T score < -2.5 | CP: 48 (17) | CP: 110 (39) | CP: 6 (2.1) |
| Controls: - | T score: -1 to -2.5 | Controls: - | Controls: - | Controls: - | |
| Spontaneous fractures | |||||
| Vujasinovic et al[8], 2021 | CP: 118 | T score < -2.5 | CP: 30 (25.4) | CP: 33 (27.9) | CP: 33 (27.9) |
| Controls: - | T score: -1 to -2.5 | Controls: - | Controls: - | Controls: - | |
| Unavailable | |||||
| Tang et al[35], 2021 | CP: 104 | T score < -2.5 | CP: 6 (5.7) | CP: 32 (30.7) | CP: - |
| Controls: - | T score: -1 to -2.5 | Controls: - | Controls: - | Controls: - | |
| Occurring in the hip, spine, or wrist |
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], 1997 | CP: 4 (28.57) | CP: - | CP: 7 (50) | CP: - | CP: 0 | CP: - | CP: - | Mean serum albumin 3.8 g/dL, 4 (28.6) had BMI < 20. Non-significant associations between osteopathy and BMI | Non-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], 2000 | CP: 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], 2008 | CP: - | 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], 2010 | CP: - | 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], 2011 | CP: - | 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], 2011 | CP: 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], 2012 | CP: - | 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], 2013 | CP: 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], 2014 | CP: - | 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], 2014 | CP: 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], 2015 | CP: - | CP: CRP: 3.15 (-), IL-6: 5.61 (-) | CP: 20 | CP: 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: 18 | Controls: 46.3 (14) | Controls: 28 (96.55) | Controls: 10 (34.4) | Controls: - | |||
| Non-significant association with IL-6 and CRP | Lower T scores were associated with serum vitamin D (P = 0.002). No association with PTH | ||||||||
| Munigala et al[24], 2016 | CP: - | 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 analysis | Increased 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], 2017 | CP: - | 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], 2018 | CP: 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 usage | Non-significant association between osteopathy and IL-6/CRP | Non-significant association between osteopathy, vitamin D and PTH | |||||||
| Kuhlmann et al[30], 2018 | CP: 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], 2018 | CP: - | CP: - | CP: - | CP: - | CP: - | CP: - | CP: - | Non-significant association with BMI | Non-significant association with (1) CP severity; (2) PERT usage |
| Controls: - | Controls: - | Controls: - | Controls: - | Controls: - | Controls: - | Controls: - | |||
| Gupta et al[33], 2019 | CP: - | 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], 2020 | CP: - | 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], 2021 | CP: 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], 2021 | CP: 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], 2021 | CP: 51 | CP: 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/CRP | Non-significant association between osteopathy and PTH |
Table 4 Metaregression of outcome measures with various covariates
| Covariates | Osteopenia | Osteoporosis | Fragility fracture | |||
| 95%CI | P value | 95%CI | P value | 95%CI | P value | |
| Sex distribution | 0.2 (-1.2-1.5) | P = 0.8 | 0.5 (-1.9-2.9) | P = 0.7 | 0.3 (-3.2-3.7) | P = 0.9 |
| Age | 0.0 (0-1) | P = 0.6 | 0.0 (-0.1-0.0) | P = 0.3 | 0.0 (-0.5-0.4) | P = 0.7 |
| DM | 0.3 (-5.5-6.0) | P = 0.9 | 0.0 (-3.9-3.8) | P = 0.9 | -13.8 (-107.4-79.8) | P = 0.3 |
| Alcohol use | 0.0 (-1.5-1.3) | P = 0.1 | 0.8 (-8.5-10.0) | P = 0.7 | -0.5 (-5.4-4.4) | P = 0.3 |
| Vitamin D | 0.0 (-0.02-0.0012) | P = 0.4 | -0.002 (-0.004-0.001) | P = 0.2 | 0.0 (-0.003-0.005) | P = 0.5 |
| PTH levels | 0.002 (-0.02-0.02) | P = 0.5 | 0.0 (-0.02-0.03) | P = 0.4 | - | - |
| PERT | 1.7 (0.6 -2.8) | P = 0.2 | 1.7 (0.6-2.8) | P < 0.0001 | 1.0 (-4.3-6.2) | P = 0.5 |
| Smoking | 0.0 (-3.6-3.6) | P = 0.9 | -0.5 (-2.9-1.9) | P = 0.6 | 2.0 (-3.4-7.9) | P = 0.3 |
| Mean BMI | NA | P = 0.9 | 0.0 (-0.12-0.21) | P = 0.6 | 0.5 (-17.2-18.2) | P = 0.8 |
- 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