Predictive analysis of osteoarthritis and chronic pancreatitis comorbidity: complications and risk factors

Abstract

Background: The comorbidity of chronic pancreatitis (CP) in patients with osteoarthritis (OA) is insufficiently studied, and the reciprocal impact of these conditions remains poorly understood. This study aimed to investigate potential predictors for the development of CP in OA patients, as well as associated complications.

Methods: A cohort of 181 patients was categorized into four groups: a control group (n=30), patients with OA (n=68), patients with CP (n=31), and patients with OA and comorbid CP (n=52). All four groups had no statistical differences in age and gender. The study utilized the WOMAC index, Visual Analog Scale (VAS), Lequesne index, biochemical assays, and advanced statistical methods to assess joint status in OA patients with comorbid CP. It explored potential predictors of comorbidity development and associated complications.

Results: The study revealed that concurrent CP in OA exacerbates progression and contributes to malnutrition. Body Mass Index (BMI) emerged as a potential predictor for CP comorbidity development in OA patients. Factors such as the WOMAC total score, fecal elastase-1, C-reactive protein (CRP), ferritin, retinol, tocopherol, 25-hydroxyvitamin D3, and BMI were found to influence the development of comorbidity of CP in OA. Additionally, Gastrointestinal Symptom Rating Scale-Diarrhea Syndrome (GSRS-DS), Gastrointestinal Symptom Rating Scale-Constipation Syndrome (GSRS-CS), Qualitative Assessment of the Symptoms and Impact of Pancreatic Exocrine Insufficiency Domain A (PEI-Q-A), retinol, tocopherol, and iron were identified as potential predictors comorbidity CP with exocrine pancreatic insufficiency in OA patients.

Conclusion: The presence of CP in OA patients exacerbates disease progression and complications, necessitating further investigation.

Keywords: adults; chronic pancreatitis; cohort study; elderly; osteoarthritis.

Figure 1

Spearman correlation correlogram used for correlations between data in patients with OA. Red: Strong negative correlation (r = −1.0). Blue: Strong positive correlation (r = 1.0).

Figure 2

Spearman correlation correlogram used for correlations between data in patients with OA+CP. Red: Strong negative correlation (r = −1.0). Blue: Strong positive correlation (r = 1.0).

Figure 3

ROC curve characterizing the relationship between BMI and the comorbidity formation of OA and CP.

Figure 4

Analysis of the sensitivity and specificity of the relationship between BMI on the comorbidity formation of OA and CP.

Figure 5

ROC curve characterizing the relationship between fecal elastase-1 levels and the formation of exocrine pancreatic insufficiency (EPI) in OA.

Figure 6

Analysis of the sensitivity and specificity regarding the association between fecal elastase-1 levels and the development of exocrine pancreatic insufficiency (EPI) in OA.

Figure 7

Principal component analysis for the OA and comorbidity presence.

Figure 8

Odds ratios estimates with corresponding 95% CI’s for predictors included to the model EPI presence in OA.

Figure 9

ROC-curve characterizing the dependence of the probability EPI presence in OA on Value of logistic function P.

Figure 10

Analysis of the sensitivity and specificity of EPI presence in OA depending on Value of logistic function P.

Figure 11

Clinical and laboratory signs of comorbid course of OA and CP. The figure illustrates notable differences between osteoarthritis (OA) patients and those with both osteoarthritis and chronic pancreatitis (OA+CP) in terms of adiposity, inflammation markers, nutrient levels, and functional indices. According to our study, OA+CP patients exhibit higher inflammation markers, lower iron levels, higher ferritin and transferrin levels, and worse WOMAC scores for pain, stiffness, and functional activity. Additionally, these patients have decreased vitamin levels. The Figure was designed using BioRender.