title: Predictors of osteodystrophy in patients with chronic nonalcoholic pancreatitis with or without diabetes.
abstract: OBJECTIVE
  To study bone mineral content (BMC), bone mineral density (BMD), vitamin D status, and bone mineral variables in patients with chronic nonalcoholic pancreatitis and to determine the relationship between pancreatic dysfunction and these variables.
  
  
  METHODS
  Thirty-one eligible nonalcoholic men with proven chronic pancreatitis and 35 male control subjects were studied. Biochemical data, variables of malabsorption, and BMD of the lumbar spine were evaluated.
  
  
  RESULTS
  In patients with chronic pancreatitis, the mean body mass index (BMI) was 18.46 kg/m² and the median 25-hydroxyvitamin D value was 15.5 (range, 5.0 to 52.0) ng/mL. A T-score of less than -2.5 was found in a higher proportion of study patients (9 of 31, 29%) than of control subjects (3 of 35, 9%). BMI correlated significantly with BMC (r = 0.426; P = .017). There was an inverse correlation between stool fat and BMC (r = -0.47; P = .03) in patients with chronic pancreatitis and steatorrhea. There was no significant correlation between serum 25-hydroxyvitamin D or biochemical variables and BMD. Patients with steatorrhea had a significantly lower BMC than did those without steatorrhea, and this difference could not be accounted for by differences in BMI, presence of diabetes, or hypovitaminosis D.
  
  
  CONCLUSIONS
  Pancreatic osteodystrophy is a novel entity consisting of osteopenia, osteoporosis, and osteomalacia in patients with chronic pancreatitis. The inverse correlation between stool fat and BMC in patients with chronic pancreatitis, the strong positive correlation between BMI and BMC, and the lack of difference in BMC between subjects with vitamin D sufficiency and those with vitamin D deficiency suggest that long-standing malabsorption with attendant chronic undernutrition is the major factor contributing to the changes in BMC.
authors: Department of Endocrinology, Christian Medical College, Vellore, India.
authors: Krishna
authors: K
authors: Sudeep
authors: Ashok
authors: A
authors: Chacko
authors: Nihal
authors: N
authors: Thomas
authors: Ratnasamy
authors: R
authors: Selvakumar
authors: Biju
authors: B
authors: George
authors: Thomas Vizhalil
authors: TV
authors: Paul
authors: Mandalam S
authors: MS
authors: Seshadri
mesh_terms: D015652:25-Hydroxyvitamin D 2 / Q000097:blood; D000328:Adult; D015992:Body Mass Index; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000209:etiology* / Q000503:physiopathology; D001842:Bone and Bones / Q000378:metabolism; D002112:Calcifediol / Q000097:blood; D003920:Diabetes Mellitus / Q000209:etiology*; D005243:Feces / Q000737:chemistry; D006801:Humans; D008055:Lipids / Q000032:analysis; D008286:Malabsorption Syndromes / Q000209:etiology / Q000503:physiopathology; D008297:Male; D044342:Malnutrition / Q000209:etiology / Q000503:physiopathology; D008875:Middle Aged; D010179:Pancreas / Q000503:physiopathology*; D050500:Pancreatitis, Chronic / Q000097:blood / Q000378:metabolism / Q000503:physiopathology*; D011446:Prospective Studies; D012720:Severity of Illness Index; D045602:Steatorrhea / Q000209:etiology / Q000503:physiopathology; D014808:Vitamin D Deficiency / Q000209:etiology / Q000503:physiopathology; D055815:Young Adult
chemical_list: D008055:Lipids; D015652:25-Hydroxyvitamin D 2; D002112:Calcifediol