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Nutr Clin Pract. 2019 Jun;34(3):387-399. doi: 10.1002/ncp.10186. Epub 2018 Aug 13.

Nutrition and Inflammatory Biomarkers in Chronic Pancreatitis Patients.

Author information

1
Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
2
St. Mary's Hospital, Richmond, Virginia.
3
Department of Medicine, Saint Louis University, St. Louis, Missouri.
4
Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama.
5
Department of Medicine, University of Michigan, Ann Arbor, Michigan.
6
Department of Medicine, Indiana University, Indianapolis, Indiana.
7
Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire.
8
Department of Medicine, Mayo Clinic, Jacksonville, Florida.
9
GI Associates LLC, Aurora Health Care, St. Luke's Medical Center, Milwaukee, Wisconsin.
10
Department of Medicine, Griffin Hospital, Yale Affiliate, New Haven, Connecticut.
11
Department of Medicine, The Ohio State University, Columbus, Ohio.
12
Department of Medicine, Medical University of South Carolina, Charleston, South Carolina.
13
Department of Medicine, University of Florida, Gainesville, Florida.
14
Department of Medicine, Brigham and Women's Hospital, Boston Massachusetts.
15
Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
16
GastroHealth and Miami Cancer Institute, Baptist Hospital, Miami, Florida.

Abstract

BACKGROUND:

Chronic pancreatitis (CP) patients frequently experience malabsorption and maldigestion, leading to micronutrient and macronutrient deficiencies. Comorbid diabetes and lifestyle habits, such as alcohol consumption, may impact nutrition status.

METHODS:

We compared micronutrient antioxidant, bone metabolism, serum protein, and inflammatory marker levels in 301 CP patients and 266 controls with no known pancreatic disease. We analyzed serum prealbumin and retinol binding protein; vitamins A, D, E, and B12; osteocalcin; tumor necrosis factor-α; and C-reactive protein (CRP). We also evaluated biomarkers among subsets of patients, examining factors including time since diagnosis, body mass index, alcohol as primary etiology, diabetes mellitus, vitamin supplementation, and pancreatic enzyme replacement.

RESULTS:

After correcting for multiple comparisons, CP patients had significantly lower levels than controls of the following: vitamin A (40.9 vs 45.4 μg/dL) and vitamin E (α-tocopherol [8.7 vs 10.3 mg/L] and γ-tocopherol [1.8 vs 2.2 mg/L]), as well as osteocalcin (7.9 vs 10 ng/mL) and serum prealbumin (23 vs 27 mg/dL). Both patients and controls who took vitamin supplements had higher serum levels of vitamins than those not taking supplements. Compared with controls, in controlled analyses, CP patients had significantly lower levels of vitamins A, D, and E (both α-tocopherol and γ-tocopherol). CP patients also had significantly lower levels of osteocalcin, serum prealbumin, and retinol binding protein, and higher CRP.

CONCLUSIONS:

CP patients demonstrated lower levels of selected nutrition and bone metabolism biomarkers than controls. Diabetes and alcohol did not impact biomarkers. Vitamin supplements and pancreatic enzyme replacement therapy improved nutrition biomarkers in CP patients.

KEYWORDS:

chronic pancreatitis; inflammation; malabsorption; micronutrient deficiency; pancreatic enzyme replacement therapy; steatorrhea

PMID:
30101991
PMCID:
PMC6642676
DOI:
10.1002/ncp.10186
[Indexed for MEDLINE]
Free PMC Article

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