Reduced bone mineral density in the first year after total pancreatectomy with islet autotransplantation (TPIAT)

Jillian K. Wothe, Robert Aidoo, Kendall R McEachron, Tasma Harindhanavudhi, Guru Trikudanathan, Martin L. Freeman, Varvara Kirchner, Timothy L. Pruett, Gregory J. Beilman, James S. Hodges, Melena D. Bellin

Research output: Contribution to journalArticlepeer-review

Abstract

Background/objectives: The effect of total pancreatectomy with islet autotransplantation (TPIAT) on bone mineral density (BMD) in patients with CP is unknown. We aimed to assess bone health in patients with CP after TPIAT. Methods: We measured BMD, BMD Z-score, and bone mineral content (BMC) for total body, lumbar spine, right and left hip in 78 patients before and after TPIAT using dual-energy X-ray absorptiometry (DXA, n = 78 pre-TPIAT, n = 65 paired pre- and 12 months post-TPIAT, n = 33 paired 12 and 18 months post-TPIAT), and tested for association with clinical history including age, smoking status, and medications using paired and two-sample t-tests, linear regression, and Fisher's exact test. Laboratory measures related to bone health were also assessed. Results: In the patients with pre-TPIAT DXA, 12% had low BMD (Z-score ≤ −2). BMD, BMD Z-score, and BMC all decreased from pre-to 12 months post-TPIAT. BMD declined by 1.7%–4.1% with the greatest change at the hips. Adjusted for change in lean and fat body mass, DXA changes remained significant for total body and hip. Serum carboxy-terminal collagen crosslinks telopeptide and alkaline phosphatase increased at 12 months post-TPIAT, suggesting possible increased bone remodeling. BMD, BMD Z-score, and BMC did not change between 12 months and 18 months in any of the four regions (p > 0.6). Conclusions: TPIAT is associated with decreases in BMD in the body, lumbar, and hip regions of patients with CP in the first year after TPIAT but these appear to stabilize between 12 and 18 months after TPIAT.

Original languageEnglish (US)
Pages (from-to)1491-1497
Number of pages7
JournalPancreatology
Volume21
Issue number8
Early online dateSep 4 2021
DOIs
StatePublished - Dec 2021

Bibliographical note

Funding Information:
MDB discloses DSMB membership for Insulet and research support from Dexcom, Viacyte, and previous support from Merck (study drug supply for clinical trial). This research was supported by the following funding agencies (PI Bellin): NIDDK ( R01 DK109124 , K23 DK084315 ), and the American Diabetes Association (grant # ADA: 1-11-CT-06 ). This research was supported by the National Institutes of Health’s National Center for Advancing Translational Sciences , grant UL1TR002494 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health's National Center for Advancing Translational Sciences.

Funding Information:
This research was supported by the following funding agencies (PI Bellin): NIDDK (R01 DK109124, K23 DK084315), and the American Diabetes Association (grant # ADA: 1-11-CT-06). This research was supported by the National Institutes of Health's National Center for Advancing Translational Sciences, grant UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health's National Center for Advancing Translational Sciences.MDB discloses DSMB membership for Insulet and research support from Dexcom, Viacyte, and previous support from Merck (study drug supply for clinical trial). This research was supported by the following funding agencies (PI Bellin): NIDDK (R01 DK109124, K23 DK084315), and the American Diabetes Association (grant # ADA: 1-11-CT-06). This research was supported by the National Institutes of Health's National Center for Advancing Translational Sciences, grant UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health's National Center for Advancing Translational Sciences.

Funding Information:
This research was supported by the following funding agencies (PI Bellin): NIDDK ( R01 DK109124 , K23 DK084315 ), and the American Diabetes Association (grant # ADA: 1-11-CT-06 ). This research was supported by the National Institutes of Health’s National Center for Advancing Translational Sciences , grant UL1TR002494 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health's National Center for Advancing Translational Sciences.

Publisher Copyright:
© 2021 IAP and EPC

Keywords

  • Chronic pancreatitis
  • Osteoporosis
  • Total pancreatectomy with islet autotransplantation

PubMed: MeSH publication types

  • Journal Article

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