血清维生素D和K水平和慢性胰腺炎患者骨质疏松症相关性研究

目的探索血清维生素D和K水平和慢性胰腺炎患者骨质疏松症相关性。方法通过双能X射线吸收测定法检测骨密度和粪弹性蛋白酶检测评估胰腺功能;检测患者血清维生素D和维生素K的水平;通过逻辑回归分析研究变量与骨密度之间的关联。结果共有211名CP患者,其中男性142例。有18%的患者有晚期CP,患有胰腺外分泌功能不全为43%。维生素D和K缺乏分别为56%和32%。骨量减少的诊断率为42%,骨质疏松症的诊断率为22%。在多变量分析中,女性、年龄和较高BMI与骨质疏松症存在相关性。在男性患者中,与骨质疏松症相关的唯一因素是维生素K缺乏症。结论 CP患者的骨病发生率很高,且维生素K缺乏作为男性骨质疏松症患者唯一的危险因素。

Correlation between serum vitamin D and K levels and osteoporosis in patients with chronic pancreatitis

Objective To explore the correlation between vitamin D and K levels and osteoporosis in patients with chronic pancreatitis (CP). Methods Bone mineral density was determined using dual-energy X-ray absorptiometry. Faecal elastase was detected to evaluate pancreatic function. Nutritional evaluation included vitamin D and vitamin K. The association between investigated variables and bone mineral density were analyzed with logistic regression analysis. Results A total of 211 CP patients were enrolled (67% men; mean age 60 years old). In total, 18% of the patients had advanced CP, 56% suffered from pancreatic exocrine insufficiency, and 43% had alcoholic etiology. 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 the only factor associated with osteoporosis in male patients.