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Vitamins D and K as Factors Associated with Osteopathy in Chronic Pancreatitis: A Prospective Multicentre Study (P-BONE Study).
Clin Transl Gastroenterol. 2018 10 15; 9(10):197.CT

Abstract

BACKGROUND

Osteopathy is common in patients with chronic pancreatitis (CP), but previous studies carry several limitations. Vitamin K is essential for bone metabolism, but its role in this setting has never been investigated. Our aim is to assess the prevalence of osteoporosis and osteopenia in CP patients, and to investigate the association between osteopathy and CP features and nutritional parameters, especially vitamin D and K levels.

METHODS

Multicentre cross-sectional study on CP patients diagnosed according to M-ANNHEIM criteria. Bone density was evaluated by dual-energy X-ray absorptiometry and pancreatic function by faecal elastase. Nutritional evaluation included vitamin D and vitamin K. Differences between patients with or without osteopathy were evaluated. The association between investigated variables and bone density were analysed with logistic regression analysis.

RESULTS

In total, 211 CP patients were enrolled at eight Centres (67% men; mean age 60). In total, 18% had advanced-marked CP, 56% suffered from pancreatic exocrine insufficiency and disease aetiology was alcoholic in 43%. Vitamin D and K were deficient in 56% and 32%, respectively. Osteopenia was diagnosed in 42% and osteoporosis in 22%. In the multivariate analysis, female sex (OR 2.78), age (OR 1.07 per year) and higher BMI (OR 0.84) were associated with the presence of osteoporosis. In male patients, the only factor associated with osteoporosis was vitamin K deficiency (OR 4.23).

CONCLUSION

The present data confirm a high rate of osteopathy in CP patients and highlight the relevance of vitamin K deficiency as only factor associated with osteoporosis in male patients for the first time.

Authors+Show Affiliations

Digestive & Liver Disease Unit, Sant'Andrea Hospital, "La Sapienza", Rome, Italy.Department for Internal Medicine I, University Hospital Regensburg, Regensburg, Germany.Gastroenterology Department, Cruces University Hospital, Baracaldo, Vizcaya, Spain.Mass Spectrometry Laboratory, Sant'Andrea University Hospital, Rome, Italy.Department of HPB Surgery, Newcastle upon Tyne, UK.Department of Endocrinology and Gastroenterology, Tartu University Hospital, University of Tartu, Tartu, Estonia.Gastroenterology and Hepatology, Gastrocentrum, Karolinska University Hospital, Stockholm, Sweden.Department of Digestive Tract Diseases, University Hospital, Lodz, Poland.Department for Internal Medicine I, University Hospital Regensburg, Regensburg, Germany.Gastroenterology and Hepatology, Gastrocentrum, Karolinska University Hospital, Stockholm, Sweden.Department NESMOS, analytical Laboratory Unit, Sant'Andrea Hospital, "La Sapienza", Rome, Italy.Digestive & Liver Disease Unit, Sant'Andrea Hospital, "La Sapienza", Rome, Italy.Gastroenterology and Hepatology, Gastrocentrum, Karolinska University Hospital, Stockholm, Sweden.Department of Medicine A, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany.Digestive & Liver Disease Unit, Sant'Andrea Hospital, "La Sapienza", Rome, Italy. capurso.gabriele@hsr.it. Biliary Endoscopy and Endosonography Division, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute IRCCS, Milan, Italy. capurso.gabriele@hsr.it.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

30323223

Citation

Stigliano, Serena, et al. "Vitamins D and K as Factors Associated With Osteopathy in Chronic Pancreatitis: a Prospective Multicentre Study (P-BONE Study)." Clinical and Translational Gastroenterology, vol. 9, no. 10, 2018, p. 197.
Stigliano S, Waldthaler A, Martinez-Moneo E, et al. Vitamins D and K as Factors Associated with Osteopathy in Chronic Pancreatitis: A Prospective Multicentre Study (P-BONE Study). Clin Transl Gastroenterol. 2018;9(10):197.
Stigliano, S., Waldthaler, A., Martinez-Moneo, E., Lionetto, L., Robinson, S., Malvik, M., Hedstrom, A., Kaczka, A., Scholdei, M., Haas, S., Simmaco, M., Delle Fave, G., Lohr, M., Simon, P., & Capurso, G. (2018). Vitamins D and K as Factors Associated with Osteopathy in Chronic Pancreatitis: A Prospective Multicentre Study (P-BONE Study). Clinical and Translational Gastroenterology, 9(10), 197. https://doi.org/10.1038/s41424-018-0066-8
Stigliano S, et al. Vitamins D and K as Factors Associated With Osteopathy in Chronic Pancreatitis: a Prospective Multicentre Study (P-BONE Study). Clin Transl Gastroenterol. 2018 10 15;9(10):197. PubMed PMID: 30323223.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamins D and K as Factors Associated with Osteopathy in Chronic Pancreatitis: A Prospective Multicentre Study (P-BONE Study). AU - Stigliano,Serena, AU - Waldthaler,Alexander, AU - Martinez-Moneo,Emma, AU - Lionetto,Luana, AU - Robinson,Stuart, AU - Malvik,Marko, AU - Hedstrom,Aleksandra, AU - Kaczka,Aleksandra, AU - Scholdei,Marius, AU - Haas,Stephan, AU - Simmaco,Maurizio, AU - Delle Fave,Gianfranco, AU - Lohr,Matthias, AU - Simon,Peter, AU - Capurso,Gabriele, Y1 - 2018/10/15/ PY - 2018/06/12/received PY - 2018/09/23/accepted PY - 2018/09/21/revised PY - 2018/10/17/entrez PY - 2018/10/17/pubmed PY - 2019/10/16/medline SP - 197 EP - 197 JF - Clinical and translational gastroenterology JO - Clin Transl Gastroenterol VL - 9 IS - 10 N2 - BACKGROUND: Osteopathy is common in patients with chronic pancreatitis (CP), but previous studies carry several limitations. Vitamin K is essential for bone metabolism, but its role in this setting has never been investigated. Our aim is to assess the prevalence of osteoporosis and osteopenia in CP patients, and to investigate the association between osteopathy and CP features and nutritional parameters, especially vitamin D and K levels. METHODS: Multicentre cross-sectional study on CP patients diagnosed according to M-ANNHEIM criteria. Bone density was evaluated by dual-energy X-ray absorptiometry and pancreatic function by faecal elastase. Nutritional evaluation included vitamin D and vitamin K. Differences between patients with or without osteopathy were evaluated. The association between investigated variables and bone density were analysed with logistic regression analysis. RESULTS: In total, 211 CP patients were enrolled at eight Centres (67% men; mean age 60). In total, 18% had advanced-marked CP, 56% suffered from pancreatic exocrine insufficiency and disease aetiology was alcoholic in 43%. Vitamin D and K were deficient in 56% and 32%, respectively. Osteopenia was diagnosed in 42% and osteoporosis in 22%. In the multivariate analysis, female sex (OR 2.78), age (OR 1.07 per year) and higher BMI (OR 0.84) were associated with the presence of osteoporosis. In male patients, the only factor associated with osteoporosis was vitamin K deficiency (OR 4.23). CONCLUSION: The present data confirm a high rate of osteopathy in CP patients and highlight the relevance of vitamin K deficiency as only factor associated with osteoporosis in male patients for the first time. SN - 2155-384X UR - https://www.unboundmedicine.com/medline/citation/30323223/Vitamins_D_and_K_as_Factors_Associated_with_Osteopathy_in_Chronic_Pancreatitis:_A_Prospective_Multicentre_Study__P_BONE_Study__ L2 - https://doi.org/10.1038/s41424-018-0066-8 DB - PRIME DP - Unbound Medicine ER -