Søren S Olesen1, Louise Kuhlman Frandsen2, Jakob Lykke Poulsen2, Peter Vestergaard3, Henrik Højgaard Rasmussen4, Asbjørn M Drewes2. 1. Centre for Pancreatic Diseases, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. Electronic address: soso@rn.dk. 2. Centre for Pancreatic Diseases, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. 3. Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark. 4. Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Centre for Nutrition and Bowel Disease, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.
Abstract
BACKGROUND: Underweight is a well-known complication of chronic pancreatitis (CP), but little is known about its prevalence in the outpatient setting. We investigated the prevalence of underweight in outpatients with CP and its association with quality of life (QOL) and various risk factors. METHODS: This was a cross-sectional study of 166 outpatients with CP that was conducted at a tertiary referral center. The primary outcome was the prevalence of underweight (body mass index [BMI] <20 kg/m2) in patients with CP compared with 160 age- and sex-matched controls. Clinical and demographic parameters including QOL, exocrine pancreatic insufficiency (EPI), pain severity, pain pattern (constant versus intermittent), opioid use, and smoking and drinking habits were analyzed for their association with BMI. RESULTS: Patients with CP had a decreased mean BMI compared with controls (22.9 ± 4.2 kg/m2 versus 26.8 ± 5.2 kg/m2; P < 0.0001). Of 166 patients with CP, 43 (26.0% [95% confidence interval: 19.8-33.1%]) were underweight compared with 15 of 160 controls (9.4% [95% confidence interval: 5.8-14.9%]; odds ratio: 3.38 [95% confidence interval: 1.79-6.38]; P = 0.0001). Several QOL scales and items were associated with underweight, including physical functioning (P = 0.024). Alcoholic etiology (P = 0.002), EPI (P = 0.004), and constant pain (P = 0.026) were independently associated with low BMI. CONCLUSIONS: One quarter of outpatients with CP are underweight and report reduced life quality compared with their normal-weight counterparts. EPI, alcoholic etiology, and pain-related symptoms are independent risk factors. Our findings emphasize the need for a multidisciplinary approach in the handling of patients with CP that focuses on alcohol cessation and the appropriate treatment of pain and EPI.
BACKGROUND: Underweight is a well-known complication of chronic pancreatitis (CP), but little is known about its prevalence in the outpatient setting. We investigated the prevalence of underweight in outpatients with CP and its association with quality of life (QOL) and various risk factors. METHODS: This was a cross-sectional study of 166 outpatients with CP that was conducted at a tertiary referral center. The primary outcome was the prevalence of underweight (body mass index [BMI] <20 kg/m2) in patients with CP compared with 160 age- and sex-matched controls. Clinical and demographic parameters including QOL, exocrine pancreatic insufficiency (EPI), pain severity, pain pattern (constant versus intermittent), opioid use, and smoking and drinking habits were analyzed for their association with BMI. RESULTS:Patients with CP had a decreased mean BMI compared with controls (22.9 ± 4.2 kg/m2 versus 26.8 ± 5.2 kg/m2; P < 0.0001). Of 166 patients with CP, 43 (26.0% [95% confidence interval: 19.8-33.1%]) were underweight compared with 15 of 160 controls (9.4% [95% confidence interval: 5.8-14.9%]; odds ratio: 3.38 [95% confidence interval: 1.79-6.38]; P = 0.0001). Several QOL scales and items were associated with underweight, including physical functioning (P = 0.024). Alcoholic etiology (P = 0.002), EPI (P = 0.004), and constant pain (P = 0.026) were independently associated with low BMI. CONCLUSIONS: One quarter of outpatients with CP are underweight and report reduced life quality compared with their normal-weight counterparts. EPI, alcoholic etiology, and pain-related symptoms are independent risk factors. Our findings emphasize the need for a multidisciplinary approach in the handling of patients with CP that focuses on alcohol cessation and the appropriate treatment of pain and EPI.