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High Prevalence of Low Bone Mineral Density in Patients With Tropical Calcific Pancreatitis

Joshi, Akhil DM*; Reddy, Sagili Vijaya Bhaskar MD*; Bhatia, Vijayalakshmi MD*; Choudhuri, Gourdas DM; Singh, Rajneesh K. MS; Singh, Nirupama MSc§; Bhatia, Eesh MD, DNB (Endocrinology)*

doi: 10.1097/MPA.0b013e31821396b2
Original Articles

Objectives: Patients with tropical calcific pancreatitis (TCP) have multiple risk factors for developing low bone mineral density (BMD). We studied BMD and serum 25-hydroxyvitamin D (25[OH]D) in north Indian TCP patients.

Methods: In a cross-sectional study, 72 TCP patients (mean age, 31 ± 10 years) and 100 controls were studied. Serum 25(OH)D was measured in all subjects; BMD was measured by dual-energy x-ray absorptiometry in 56 adult patients and 4 children and compared with a reference Indian population.

Results: Mean BMD and BMD Z-scores at the lumbar spine and total hip were significantly lower in all age groups. The BMD Z-scores at the lumbar spine and total hip were −1.0 ± 1.0 and −1.2 ± 1.2, respectively. Low bone density (Z-score ≤ −2 at ≥1 sites) was present in 22 (39%) adult patients and 3 of the 4 children studied. On multivariate analysis, BMD Z-scores were positively associated with body mass index and inversely with pancreatitis. Vitamin D deficiency (25[OH]D < 50 nmol/L) was equally prevalent in patients (86%) and controls (85%).

Conclusions: Despite their young age, patients with TCP have significantly low BMD. Measures to improve nutrition should be instituted in all TCP patients from an early age.

From the Departments of *Endocrinology, †Gastroenterology, ‡Surgical Gastroenterology, and §Dietetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Received for publication July 2, 2010; accepted February 1, 2011.

Reprints: Eesh Bhatia, MD, DNB (Endocrinology), Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India (e-mail:

Drs Joshi and Reddy equally contributed to this study.

© 2011 Lippincott Williams & Wilkins, Inc.