triolein and Pancreatic-Diseases

The carbon-14-triolein absorption test was used to investigate fat absorption and its response to pancreatic enzyme replacement therapy in 10 men with pancreatic steatorrhoea. Absorption was increased in all, from 1,14 +/- 1,2% of the dose per hour (group mean +/- SD) to 2,85 +/- 2,33% (P less than 0,01) by the simultaneous administration of 8 tablets of enteric-coated pancreatic enzymes (Nutrizym; Merck). In patients with normal or high gastric acid secretion, neutralization of gastric acid with 30 ml magnesium trisilicate had no effect on absorption while the addition of an extract of gastric secretions (Enzynorm; Noristan) to the therapy of the 1 achlorhydric patient improved absorption from 2,2% to 3,81%. The 14C fat test offers a rapid and more acceptable alternative method for determining individual response to pancreatic enzyme replacement therapy than the conventional 72-hour faecal fat excretion measurement. The enteric-coated pancreatin preparation used in this study appears to be optimally effective under conditions of normal gastric acid secretion.

Topics: Adult; Amylases; Bromelains; Carbon Radioisotopes; Clinical Trials as Topic; Drug Combinations; Evaluation Studies as Topic; Gastric Acid; Humans; Intestinal Absorption; Lipase; Malabsorption Syndromes; Male; Pancreatic Diseases; Tablets, Enteric-Coated; Triolein; Trypsin

The 14C-triolein breath test, a recognised index of fat absorption, and the p-aminobenzoic acid (PABA) test, a 'tubeless' test of exocrine pancreatic function, have both been widely used in the diagnosis of malabsorption and exocrine pancreatic insufficiency. This study evaluates the potential of a combination of both tests in the investigation of fat absorption and exocrine pancreatic function. Combination of the tests has become technically feasible because of the introduction of high pressure liquid chromatography as the preferred method of analysis for PABA, and use of p-aminosalicylic acid (PAS) as the marker for PABA absorption and metabolism. We studied 25 healthy subjects, 11 patients with exocrine pancreatic disease and 12 patients with gastrointestinal disease. The combined test identified subjects with reduced fat absorption and distinguished subjects with exocrine pancreatic insufficiency from those with an intestinal cause of fat malabsorption. The test could be completed in 7 h and had high patient acceptability. These findings suggest that the combined 14C-triolein breath test and PABA test can be used as a non-invasive, 1-day investigation of fat absorption and exocrine pancreatic function.

Topics: 4-Aminobenzoic Acid; Adult; Aged; Aminosalicylic Acid; Breath Tests; Carbon Dioxide; Diarrhea; Dietary Fats; Female; Gastrointestinal Diseases; Humans; Intestinal Absorption; Malabsorption Syndromes; Male; Middle Aged; Pancreatic Diseases; Triolein

The triolein breath test (TBT) is a simple, noninvasive technique for the evaluation of steatorrhea. However, because it depends on intermediary hepatic processes, and because both liver damage and pancreatic dysfunction often co-exist in the alcoholic, the overall usefulness of the test in patients with liver injury was reassessed. We found that even in the absence of steatorrhea, a majority of patients with advanced liver injury (alcoholic hepatitis, cirrhosis, or both) had abnormal TBT results that failed to correct with pancreatic extract. In contrast, patients with less severe lesions (steatosis) had results that were not significantly different from those in normal controls. Inasmuch as the abnormal TBT results in patients with advanced alcohol-induced lesions did not correct with pancreatic extract, the test may not accurately differentiate pancreatic from nonpancreatic steatorrhea in some alcoholics.

Topics: Breath Tests; Carbon Radioisotopes; Celiac Disease; Fatty Liver, Alcoholic; Humans; Liver Diseases, Alcoholic; Middle Aged; Pancreatic Diseases; Pancreatic Function Tests; Triolein

Development of a standardized procedure for the titrimetric assay of lipase has been suggested. Comparative studies with triolein und olive oil were therefore undertaken. Optimal conditions, such as pH, substrate and glycocholate concentrations, etc. were determined for the assay with triolein. The results agree with those obtained earlier with olive oil as substrate. Experience with the quality of various reagents used since 1966 is reported. Problems of methodology are then discussed, especially the incomplete characterization and purity of the bile acid preparations, and their effects on the test conditions. A critical analysis shows that two point tests with modifications of the continuous titration cannot give reliable results. Haemolysis and its effect on catalytic activity of lipase are used to illustrate the consequences of the uncritical acceptance of data from the literature. Furthermore, the required sensitivity of the analytical equipment, operational errors, and the uncritical evaluation and interpretation of analytical data are discussed. The first experiments to be performed with the addition of colipase are described, and the question of whether this cofactor should be used routinely for test purposes is considered. The problem of whether lipoproteinlipase can be quantitatively inhibited is discussed. In view of the outlay on apparatus and the time required for the assay, continuous titration is definitely not suitable for routine screening purposes. On the other hand, simpler methods that give reproducible quantitative results have not yet been developed.

Topics: Catalysis; Glycocholic Acid; Humans; Hydrogen-Ion Concentration; Lipase; Oils; Pancreatic Diseases; Renal Dialysis; Triolein

A direct test of lipid absorption has been developed using [3H]glycerol triether as a lipid marker and [14C]glycerol trioleate as the test lipid. Percentage absorption of triolein is calculated from the isotope ratio ingested and excreted in faeces. The test is independent of a complete faecal collection, reproducible and shows little day to day variation. Absorption in 25 normal subjects ranged from 96.4--100% (mean 98.6, S.D. +/- 1.15). In 24 patients with known pancreatic or small intestinal disease and steatorrhoea absorption ranged from 0.01% to 89.9%. The test has also been assessed by comparison with a standard Lundh test and faecal fat estimation in 34 patients.

Topics: Adult; Aged; Carbon Radioisotopes; Celiac Disease; Fats; Feces; Female; Glycerol; Humans; Intestinal Absorption; Intestinal Diseases; Male; Middle Aged; Pancreatic Diseases; Triolein; Tritium

Topics: Adult; Calcinosis; Calcium; Cholecystokinin; Cholesterol; Chronic Disease; Glucose Tolerance Test; Humans; Insulin; Iodine Radioisotopes; Male; Middle Aged; Pancreas; Pancreatic Diseases; Pancreatitis; Phosphorus; Triolein

Topics: Animals; Bile Acids and Salts; Carbon Isotopes; Celiac Disease; Fatty Acids, Nonesterified; Gastrointestinal Motility; Hyperthyroidism; Intestinal Absorption; Linoleic Acids; Lipid Metabolism; Malabsorption Syndromes; Oleic Acids; Pancreatic Diseases; Rats; Triglycerides; Triolein

Topics: Animals; Diagnosis, Differential; Dog Diseases; Dogs; Female; Intestinal Absorption; Iodine; Iodine Isotopes; Malabsorption Syndromes; Male; Oleic Acids; Pancreatic Diseases; Triolein

Topics: Animals; Dogs; Fats; Intestinal Absorption; Iodine Radioisotopes; Lipase; Pancreatic Diseases; Pancreatic Extracts; Triolein

Topics: Amylases; Clinical Enzyme Tests; Diagnosis; Diagnostic Tests, Routine; Feces; Fluids and Secretions; Gastrointestinal Hormones; Iodine Isotopes; Lipase; Pancreatic Diseases; Pancreatitis; Secretin; Starch; Triolein

Topics: Adult; Female; Humans; Male; Middle Aged; Oleic Acids; Pancreatic Diseases; Triolein

Topics: Humans; Oleic Acids; Pancreatic Diseases; Triolein

Vitamin A acetate and vitamin A alcohol, triolein I(131), oleic acid I(131), and fat balance tests have been assessed in studies on cases of coeliac disease, pancreatic insufficiency, and some disorders of the small intestinal wall. In coeliac disease a very low serum carotene and flat vitamin A absorption curves have been noted. The contrast between vitamin A acetate and alcohol curves has been clearly shown in cases of pancreatic disorder showing maldigestion. The correlation between vitamin A and triolein I(131) absorption (0.89) is closer than that between vitamin A and fat balance. In assessing intestinal absorption serum carotene figures are of value only if very low figures are found.

Topics: Alcohols; Celiac Disease; Disease; Diterpenes; Fats, Unsaturated; Humans; Intestinal Diseases; Intestine, Small; Intestines; Lipid Metabolism; Oleic Acid; Pancreas; Pancreatic Diseases; Retinyl Esters; Triolein; Vitamin A