Peculiarities of the Management of Osteoporosis in Patients with Chronic Pancreatitis

Abstract

The purpose of the study was to investigate the effect of zolendronic acid on bone mineral density in patients with osteoporosis and chronic pancreatitis Materials and methods. 32 patients (average age of 57.7 ± 2.8 years) with decreased bone mineral density and chronic pancreatitis took part in the study. All examined patients were in menopause with an average duration of 4.8 ± 2.5 years. The study included patients with chronic pancreatitis lasting at least 10 years and with preserved exocrine function of the pancreas according to the level of fecal pancreatic elastase. Inclusion criterion was the absence of other concomitant diseases. Bone mineral density was determined using a DEXXUM X-ray densitometer using dual-energy absorptiometrsy. Results and discussion. An isolated decrease in the mineral density of the lumbar spine was diagnosed in 28 patients. In 9 patients there was a combination of a decrease in the mineral density of the spine with a decrease in the mineral density of the femur. The average T criterion of the vertebrae was -2.19 ± 0.18. The average T criterion of the femoral neck was 6 ± 0.5. In order to preserve and restore the mineral density of bone tissue, these patients were recommended to reduce the factors contributing to the loss of bone mass, mainly by stopping the use of alcohol and smoking. The patients were recommended to exercise as much as possible under the supervision of a rehabilitator, especially exercises aimed at improving the mechanics of the spine. The patients received 5 mg of zolendronic acid intravenously as a single drip and took 1500 mg of calcium and 800 IU of vitamin D daily for a year. An isolated decrease in the mineral density of the lumbar spine was diagnosed in 18 patients, in 5 patients there was a combination of a decrease in the mineral density of the spine with a decrease in the mineral density of the femur, the average T criterion of the vertebrae was 1.2 ± 0.12 (р = 0.031), the average femoral neck was -0.8 ± 0.1 (р = 0.025). The level of alanine transaminase, aspartate transaminase, alkaline phosphatase, gammaglutamyl transpeptidase, and amylase levels did not reveal any abnormalities. After the introduction of zolendronic acid, 5 patients experienced an increase in temperature to febrile indicators within 2-3 days. None of the patients showed signs of bone fractures during the observation period. Conclusion. Administration of zolendronic acid to patients with decreased bone mineral density on the background of chronic pancreatitis is safe and highly effective