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Cortical and trabecular bone microarchitecture and turnover in alcohol-induced chronic pancreatitis: a histomorphometric study

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Abstract

Alcohol-induced chronic pancreatitis is associated with bone loss, but bone histomorphometric data describing the mechanism of cortical (Ct) and trabecular (Tb) bone loss are scarce. In this case-control study, we investigated 13 black male patients aged 41.2 ± 8.9 years with alcohol-induced chronic pancreatitis by routine iliac crest cortical and trabecular histomorphometry and by biochemistry relevant to bone, liver function, and iron overload. Patients showed lower values for Ct thickness (P = 0.018), endocortical (Ec) wall thickness (P = 0.0002), Tb bone volume (0.019), Tb thickness (0.001), Tb wall thickness (P < 0.0001), Ec osteoid thickness (P = 0.001), Ec mineral apposition rate (P = 0.011), and Ec bone formation rate (P = 0.035). Ec eroded surface (P = 0.004) was elevated compared to controls. Tb osteoid thickness (P = 0.14) and Tb mineral apposition rate (P = 0.195) tended to be lower than in controls. Levels of 25-hydroxyvitamin D (P < 0.005), serum magnesium (P = 0.02), and ascorbic acid (P = 0.049) were lower and urine calcium/creatinine ratios higher than in controls. Alkaline phosphatase and gamma-glutamyl transpeptidase (GGT) were negatively correlated but iron markers were positively correlated with bone structural and formation variables. The histomorphometric data were found to be consistent with alcohol bone disease. Osteomalacia was not a feature. Secondary pathogenetic factors were liver disease, hypovitaminosis D and C, diabetes mellitus, and possibly chronic pancreatitis.

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Acknowledgments

This study was funded by the Medical Research Council of South Africa, and the University of the Witwatersrand, Johannesburg, South Africa.

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Authors and Affiliations

  1. MRC Mineral Metabolism Research Unit, University of the Witwatersrand, 2050, Johannesburg, South Africa

    Christine M. Schnitzler & Julia M. Mesquita

  2. Division of Orthopaedic Surgery, University of the Witwatersrand, Johannesburg, South Africa

    Julia M. Mesquita

  3. Department of Internal Medicine, Chris Hani-Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa

    Roy Shires

  4. 608 Helderberg Village, P. Bag X19, Somerset West, 7129, South Africa

    Christine M. Schnitzler

Authors
  1. Christine M. Schnitzler
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  2. Julia M. Mesquita
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  3. Roy Shires
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Correspondence to Christine M. Schnitzler.

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Schnitzler, C.M., Mesquita, J.M. & Shires, R. Cortical and trabecular bone microarchitecture and turnover in alcohol-induced chronic pancreatitis: a histomorphometric study. J Bone Miner Metab 28, 456–467 (2010). https://doi.org/10.1007/s00774-009-0151-x

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  • DOI: https://doi.org/10.1007/s00774-009-0151-x

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