Pancreatic exocrine insufficiency in patients with osteoporosis

Osteoporosis is a multisystemic bone disorder influenced by genetic, hormonal, and environmental factors. Its high prevalence, particularly in the context of an aging global population, renders it a major public health concern. While its associations with various organ systems have been well established, recent studies have drawn attention to its potential links with the gastrointestinal system. Pancreatic exocrine insufficiency (PEI), a condition characterized by inadequate secretion or activity of pancreatic digestive enzymes, is known to impair nutrient absorption and may negatively impact bone health. Based on this premise, the present study aimed to assess the prevalence of PEI in individuals with osteoporosis. This cross-sectional study included 201 postmenopausal women, comprising 109 individuals with osteoporosis and 92 age-matched controls without osteoporosis. All participants were evaluated for PEI using the Pancreatic Exocrine Insufficiency Questionnaire (PEI-Q), and relevant biochemical parameters were recorded. The prevalence of PEI was significantly higher among patients with osteoporosis (p = 0.003). In addition, PEI-Q scores were notably elevated in the osteoporotic group compared to controls (p = 0.001). Given the debilitating consequences of osteoporosis, early diagnosis and comprehensive management are essential. PEI, a frequently overlooked gastrointestinal condition, may contribute to the pathogenesis of osteoporosis through malabsorption-related mechanisms. Therefore, screening for and addressing PEI in osteoporotic patients may represent a valuable adjunct to conventional osteoporosis treatment strategies. Keywords: Osteoporosis, Malabsorption, Pancreatic Exocrine Insufficiency, PEI-Q Questionnaire