Effect of acute pancreatitis on the risk of developing osteoporosis: A nationwide cohort study

PLoS One. 2017 Jun 12;12(6):e0179358. doi: 10.1371/journal.pone.0179358. eCollection 2017.

Abstract

Purpose: Chronic exocrine pancreatic insufficiency can lead to osteoporosis. However, the incidence and risk of osteoporosis after acute inflammation of pancreas remained known. Thus, we conducted a population-based cohort study to clarify the association between acute pancreatitis (AP) and osteoporosis.

Methods: Patients newly diagnosed with AP with index date between 2000 and 2011 were identified from the National Health Insurance Research Database. Osteoporosis were defined according to the International Classification of Diseases, Ninth Revision, Clinical Modification codes. We applied age-, sex-, and comorbidities-adjusted variable Cox proportional hazard models for assessing the association between AP and osteoporosis. Moreover, these models were used to adjust for the influences of patient characteristics and comorbidities.

Results: In this study, 4,016 patients were included in the AP cohort (males, 67.9%; mean age, 51.8 years) and 4,016 matched controls in the non-AP cohort. After a mean follow-up period of 4.97 and 5.21 years in the AP and non-AP cohorts, respectively, the incidence of osteoporosis was 8.22 per 1000 person-years in the AP cohort. The AP cohort had a higher risk [adjusted hazard ratio (aHR) = 1.27, 95% confidence interval (CI) = 1.02-1.58] of osteoporosis than did the non-AP cohort. The risk of osteoporosis was highest in the female patients of the AP cohort (aHR = 2.26, 95% CI = 1.85-2.76) and patients aged 50-64 years (aHR = 4.14, 95% CI = 3.13-5.47).

Conclusion: AP patients are at a risk of osteoporosis, especially female gender and age 50-64 years. Those with > 3 episodes of AP had highest significant risk of developing osteoporosis.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Cohort Studies
  • Comorbidity
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Osteoporosis / epidemiology*
  • Osteoporosis / etiology*
  • Pancreatitis / complications*
  • Pancreatitis / epidemiology*
  • Population Surveillance
  • Probability
  • Proportional Hazards Models
  • Risk

Grants and funding

This study was supported by the grants from the Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence, (MOHW105-TDU-B-212-133019); China Medical University Hospital and the Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10501010037); the NRPB Stroke Clinical Trial Consortium (MOST105-2325-B-039-003); the Tseng-Lien Lin Foundation, Taichung, Taiwan; the Taiwan Brain Disease Foundation, Taipei, Taiwan; Katsuzo and Kiyo Aoshima Memorial Funds, Japan. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding was received for this study.