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.
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.
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%).
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: firstname.lastname@example.org).
Drs Joshi and Reddy equally contributed to this study.