cholecalciferol and Pancreatitis--Chronic

Vitamin D deficiency is prevalent in chronic pancreatitis (CP), but the optimal route and dose of vitamin D supplementation are unknown. We evaluated the relative efficacy of two different doses of intramuscular (i.m.) vitamin D(3) in patients with CP and vitamin D insufficiency. In a double-blind randomized study, 40 patients with tropical calcific pancreatitis with serum 25-hydroxyvitamin D (25OHD) <75 nmol/L (mean 27.0 ± 14.5 nmol/L, <50 nmol/L in 90 %) were divided into three groups. Groups 1 and 2 received 600,000 IU (15,000 μg) and 300,000 IU (7,500 μg) i.m. cholecalciferol, respectively, while group 3 received i.m. saline. All groups received 1 g calcium and 500 IU (12.5 μg) vitamin D(3) orally daily and were studied for 9 months. The primary outcome was the proportion of patients with vitamin D sufficiency (25OHD >75 nmol/L) at 6 months. Vitamin D sufficiency was significantly different in the three groups (85, 29, and 0 % in groups 1, 2, and 3, respectively; p < 0.001). Mean 25OHD remained >75 nmol/L in months 1-6 in group 1 but reached a lower level (50-75 nmol/L) at these time points in group 2. At 6 months, serum alkaline phosphatase decreased significantly only in group 1 (230 ± 73 vs 165 ± 39 IU/L, p = 0.004). No patient in any group developed hypervitaminosis D or hypercalcemia. In conclusion, in patients with CP, a single i.m. injection of 600,000 IU was more effective at achieving vitamin D sufficiency over 6 months compared with 300,000 IU vitamin D(3). (Clinical Trials.gov number NCT00956839).

Topics: Adult; Bone Density Conservation Agents; Calcinosis; Cholecalciferol; Dose-Response Relationship, Drug; Double-Blind Method; Female; Humans; Male; Pancreatitis, Chronic; Prospective Studies; Vitamin D Deficiency

Patients with chronic pancreatitis (CP) often develop fat malabsorption and are susceptible to hypovitaminosis D.. We wanted to evaluate the intestinal uptake of cholecalciferol in patients with CP and fat malabsorption.. We did a prospective placebo-controlled study including patients with verified CP and fat malabsorption. They were randomized to 10 weeks of (A) ultraviolet radiation B (UVB) 6 min weekly in a commercial tanning bed, (B) vitamin D supplement 1,520 IU/daily, or (C) placebo. The vitamin D metabolites 25-hydroxyvitamin D (25OHD) and 1,25-dihydroxyvitamin D (calcitriol) were quantified at the start and end of the study.. In total 30 patients were randomized and 27 completed the study. Compliance to tablets and tanning sessions was >80%. The changes in 25OHD levels in group B (32.3 nmol/l; 95% CI 15-50) were significantly greater than changes in group A (p < 0.001) and group C (p < 0.001). Changes in group A (1.1 nmol/l) did not differ from the placebo group (p = 0.9). Changes in calcitriol levels were identical between groups.. Daily vitamin D supplements increased 25OHD in patients with CP compared to placebo whereas weekly tanning bed sessions did not.

Topics: Administration, Oral; Adult; Aged; Cholecalciferol; Dietary Fats; Exocrine Pancreatic Insufficiency; Female; Humans; Intestinal Absorption; Male; Middle Aged; Pancreatitis, Chronic; Patient Compliance; Radiotherapy; Sunbathing; Ultraviolet Rays; Ultraviolet Therapy; Vitamin D Deficiency; Vitamins

The expediency of Vitrum Calcium 600 + D400 and Risendros using in the complex treatment of the patients with a chronic pancreatitis and osteodeficiency syndrome has been proved. As a result the status of the bone mineralization is improved, the mineral density of the bone tissue is increased.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone and Bones; Bone Density; Bone Density Conservation Agents; Calcification, Physiologic; Calcium Carbonate; Cholecalciferol; Etidronic Acid; Female; Humans; Male; Middle Aged; Osteoporosis; Pancreatitis, Chronic; Risedronic Acid

There are still too few conclusive reports about conspicuous vitamin D-deficiency in young female patients with chronic pancreatitis, or any connection of the deficiency to the severity of the disease. Therefore the aim of this study was to examine marker of vitamin D3 metabolism in female patients with episode of biliary pancreatitis to determine if increased severity of the disease would correlate with impaired vitamin D3 metabolism.. Between 1996 and 2003, we investigated 53 premenopausal patients with an average age of approximately 33 years suffering from an episode of chronic pancreatitis, as well as 30 female healthy controls with an average age of 32.4 years. The severity of chronic pancreatitis in patients was determined via endoscopic retrograde cholangiopancreaticography (ERCP) and assigned to 1 of 3 grades based on the Cambridge classification. Additional parameter assessed were demographics, smoking, consumption of alcohol and CD-transferrin, fasting metabolic parameters, biochemical markers of vitamin D3 metabolism and fecal elastase 1. None of the patients received hormone replacement therapy, Vitamin D or Calcium-supplementation.. The serum levels of 1,25-dihydroxyvitamin D [1,25(OH2)D] were significantly reduced compared to female healthy controls. Fecal elastase 1 correlated with this classification of severity of chronic pancreatitis (p < 0.01). Furthermore, fecal elastase 1 of patients correlated the same way with both D-vitamins (p <0.01). The level of both D3 vitamins in patients were significantly lowered when the content of fecal elastase 1 was under 200 microg/g compared to the others [for 1,25-(OH2)D3 p < 0.01; 25-OH- D3 p < 0.01].. Premenopausal patients with chronic pancreatitis are at risk of developing decreased levels of 1,25(OH2)D3. This fact may contribute to a negative calcium balance and alteration of bone metabolism. Therefore, ERCP and fecal elastase 1 verify the severity grade of a chronic pancreatitis, and thus show a vitamin D3 deficiency in young women, depending on the progress of disease.

Topics: Adult; Calcifediol; Cholecalciferol; Cross-Sectional Studies; Feces; Female; Germany; Humans; Pancreatic Elastase; Pancreatitis, Chronic; Vitamin D Deficiency