Bone Abstracts

Background and aims: Cirrhosis and chronic pancreatitis (CP) are accompanied by inflammation and malnutrition. Both conditions may affect bone metabolism negatively and facilitate bone fractures. The objective of this study was to evaluate the risk of fractures among patients with CP or cirrhosis and the impact of fat malabsorption on fracture risk among patients with CP.

Methods: Using the Danish National Patient Register, we did a retrospective cohort study and identified patients diagnosed with either CP or cirrhosis. Each patient was compared with 10 age- and gender matched controls. We also assessed the risk of fractures among CP patients receiving pancreatic enzyme substitution (PES) for fat malabsorption.

Results: A total of 20.769 (35.5% females) patients with cirrhosis and 11.972 (33.5% females) patients with CP were included. During the follow-up time, fractures were registered for 3954 patients with cirrhosis and 2594 patients with CP. The adjusted hazard ratio (HR) for any fracture was 2.4 (95% CI 2.2–2.5) among patients with cirrhosis and 1.7 (95% CI 1.6–1.8) for patients with CP. The risk of low-trauma fractures was significantly higher among younger individuals. Alcohol as etiology was associated with increased risk of fracture compared to patients with a non-alcoholic cirrhosis (P<0.0001) and CP (P<0.0001). Patients with CP receiving PES for fat malabsorption had lower risk of fractures than other CP patients (HR 0.8; 0.7–0.9) and increasing exposure to PES was associated with increasing risk of fracture.

Conclusions: Patients, and especially younger patients, with cirrhosis or CP have increased risk of fractures of all types.