cholecalciferol and Pancreatitis

Topics: Acute Disease; Adult; Animals; Calcitonin; Calcium; Calcium, Dietary; Cholecalciferol; Chronic Disease; Fatty Acids; Homeostasis; Humans; Hypocalcemia; Hypophysectomy; Malabsorption Syndromes; Pancreas; Pancreatic Diseases; Pancreatitis; Parathyroid Hormone; Pituitary Gland; Thyroxine

There are still too few conclusive reports about conspicuous vitamin D deficiency in patients with chronic pancreatitis, or any connection of the deficiency to the severity of the disease. Between October 1999 and September 2000, we investigated 42 patients at an average age of 53 years, suffering from chronic pancreatits, as well as 20 healthy male controls at an average age of 49 years. Serum levels of D3 vitamins, 1,25-(OH)2-vitamin D3 and 25-(OH)-vitamin D3, as well as the concentration of fecal elastase 1 were determined in patients and controls. Furthermore, the severity of chronic pancreatitis in patients was determined via endoscopic retrograde cholangiopancreatography (ERCP) into 3 grades, based on the Cambridge classification. Elastase 1 in feces revealed sensitivities of 14%, 87%, and 95% for Cambridge-grades I, II, and III, respectively, and correlated significantly with this classification of severity of chronic pancreatitis (P < 0.01). In patients with Cambridge-grade II and III 1,25-(OH)2-D3 was markedly decreased (26.7 +/- 7.7 pg/ml and 27.6 +/- 9.0 pg/ml) compared to those with Cambridge-grade I (38.0 +/- 10.5 pg/ml; between I and II P = 0.027, between I and III P = 0.033). 25-(OH)-D-3 did not differ significantly within the various Cambridge-grade groups (P = 0.07). Nevertheless, vitamin D3 and fecal elastase 1 in patients correlated significantly (P < 0.01) and, compared to controls, both were extremely low (means in patients: fecal elastase 1 140.7 +/- 75.7 microg/g, 1,25-(OH)2-D3 29.9 +/- 9.5 pg/ml, 25-(OH)-D3 26.7 +/- 9.7 nmol/liter; controls: fecal elastase 1 694.9 +/- 138.6 microg/g, 1,25-(OH)2-D3 67.5 +/- 4.3 pg/ml, 25-(OH)-D3 69.5 +/- 13.5 nmol/liter). The amounts of both D3 vitamins in patients were significantly lower when the content of fecal elastase 1 was under 200 microg/g compared to the others [for 1,25-(OH)2-D3 P < 0.01, for 25-(OH)-D3 P < 0.05]. Therefore, ERCP and fecal elastase 1 verify the severity grade of a chronic pancreatitis, and thus show a vitamin D3 deficiency, depending on the progress of the disease. There seems to be a connection between inflammatory pancreas destruction (Cambridge classification), exocrine insufficiency (fecal elastase 1), and perhaps even the characteristics of sterol-binding of pancreatic elastase 1, which seems to be relevant for vitamin D supply.

Topics: Adult; Calcifediol; Calcitriol; Case-Control Studies; Cholangiopancreatography, Endoscopic Retrograde; Cholecalciferol; Chronic Disease; Feces; Humans; Male; Middle Aged; Pancreatic Elastase; Pancreatitis; Severity of Illness Index

Chronic pancreatitis is a longlasting inflammatory disease manifested clinically in the advanced stage by malabsorption syndrome. Its manifestations include also changes in the calcium metabolism and the occurrence of osteoporosis and osteomalacia or their combination. The objective of the study was to assess the vitamin D3 blood concentration in patients with chronic pancreatitis. The group comprised 15 patients (8 men and 7 women), median age 45.0 years. The authors found a significantly reduced serum concentration of vitamin D3 (p < 0.01) in patients with chronic pancreatitis. They assume that vitamin D deficiency is one of the decisive causes of bone complications in prolonged pancreatitis. Supplementation with vitamin D or its metabolites is then a necessary part of preventive and therapeutic provisions.

Topics: Adult; Aged; Cholecalciferol; Chronic Disease; Female; Humans; Male; Middle Aged; Osteomalacia; Osteoporosis; Pancreatitis; Vitamin D Deficiency

Topics: Adult; Alcoholic Intoxication; Anti-Bacterial Agents; Bile Acids and Salts; Blind Loop Syndrome; Celiac Disease; Cholecalciferol; Chronic Disease; Feces; Humans; Intestinal Absorption; Intestinal Diseases; Intubation, Gastrointestinal; Jejunum; Malabsorption Syndromes; Male; Osteomalacia; Pancreatic Extracts; Pancreatitis; Tritium; Vitamin D Deficiency

Topics: Adolescent; Adult; Aged; Celiac Disease; Cholecalciferol; Female; Gastrectomy; Humans; Intestinal Absorption; Lipid Metabolism; Liver Cirrhosis; Malabsorption Syndromes; Male; Middle Aged; Osteomalacia; Pancreatitis; Protein-Losing Enteropathies; Rickets; Tritium; Vitamin D Deficiency