The prevalence of fat-soluble vitamin deficiencies and a decreased bone mass in patients with chronic pancreatitis

Sikkens, Edmée C.M.; Cahen, Djuna L.; Koch, Arjun D.; Braat, Henri; Poley, Jan–Werner; Kuipers, Ernst J.; Bruno, Marco J.

doi:10.1016/j.pan.2013.02.008

Cited by 170 publications

(136 citation statements)

References 39 publications

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“…A trend towards a higher prevalence of deficiency in a study of 40 CP patients with PEI (53%) and notably those with PEI not receiving PERT (78%) was observed versus those without PEI (33%) [58]. Other studies have reported high prevalence of vitamin D insufficiency in CP, with no significant difference between those with and without PEI [41,55,61].…”

Section: Vitamin Dmentioning

confidence: 83%

“…The reported prevalence of vitamin D deficiency in patients with CP is high in most studies, ranging from 33% to 87% regardless of PEI status or PERT use [41,55,58,59]. A trend towards a higher prevalence of deficiency in a study of 40 CP patients with PEI (53%) and notably those with PEI not receiving PERT (78%) was observed versus those without PEI (33%) [58].…”

Section: Vitamin Dmentioning

confidence: 99%

“…However, the majority of studies in CP populations have concluded that vitamin A deficiency is not a clinically significant problem in PEI [41,58e60]. Recent studies found abnormally low serum levels in only 1/40 patients with CP and no association between low FE-1 and serum levels [58], and no relationship between FE-1 level and vitamin A deficiency [41].…”

Section: Vitamin Amentioning

confidence: 99%

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Clinical, anthropometric and laboratory nutritional markers of pancreatic exocrine insufficiency: Prevalence and diagnostic use

2015

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Section: Vitamin Dmentioning

confidence: 83%

Section: Vitamin Dmentioning

confidence: 99%

Section: Vitamin Amentioning

confidence: 99%

See 1 more Smart Citation

Clinical, anthropometric and laboratory nutritional markers of pancreatic exocrine insufficiency: Prevalence and diagnostic use

2015

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“…These include cystic fibrosis, inflammatory bowel disease, pancreatitis, chronic kidney disease and osteoporosis [15][16][17][18][19]. This review will not address the relationship between vitamin K and these diseases, despite our ongoing interests.…”

Section: Vitamin K and Inflammationmentioning

confidence: 99%

Anti-Inflammatory Actions of Vitamin K

Hodges¹,

Pitsillides²,

Ytrebø³

et al. 2017

Vitamin K2 - Vital for Health and Wellbeing

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Naphthoquinone compounds have received attention for their ability to regulate diseases from bacterial and parasite infections through to chronic human diseases. Inflammation is widely considered to be at the root of many chronic diseases. The reports of anti-inflammatory activity of naphthoquinones, including vitamin K1 (phylloquinone) and vitamin K2s (menaquinones), are of interest due to their very low toxicity. Most of the evidence for the anti-inflammatory mechanisms of vitamin K suggests a role in the inhibition of the cell signalling complex nuclear factor kappa-B (NF-κB).

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“…It is recognised that certain markers such as magnesium, haemoglobin, albumin and retinol binding protein can be used to predict presence of PEI [31] and deficiencies of fat soluble vitamins can be present in up to 63% of patients with CP sometimes presenting prior to onset of exocrine insufficiency [45]. The risk of osteoporosis and decreased bone mineral density is also well described in PEI [46].…”

Section: Pancreatic Enzyme Replacement Therapymentioning

confidence: 99%

Should we Investigate Gastroenterology Patients for Pancreatic Exocrine Insufficiency? A Dual Centre UK Study

Campbell

Sanders

Francis

et al. 2016

JGLD

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Background & Aims: Pancreatic exocrine insufficiency may be under recognised in gastroenterological practice. We aimed to identify the prevalence of pancreatic insufficiency in secondary care gastroenterology clinics and determine if co-morbidity or presenting symptoms could predict diagnosis. A secondary aim was to assess response to treatment. Methods: A dual centre retrospective analysis was conducted in secondary care gastroenterology clinics. Patients tested for pancreatic exocrine insufficiency with faecal elastase-1 (FEL-1) between 2009 and 2013 were identified in two centres. Demographics, indication and co-morbidities were recorded in addition to dose and response to pancreatic enzyme replacement therapy. Binary logistic regression was used to assess if symptoms or co-morbidities could predict pancreatic insufficiency. Results: 1821 patients were tested, 13.1% had low FEL-1 (<200μg/g). This prevalence was sub-analysed with 5.4% having FEL-1 100-200μg/g (mild insufficiency) and 7.6% having faecal elastase readings <100μg/g. Low FEL-1 was most significantly associated with weight loss or steatorrhoea. Co-morbidity analysis showed that low levels were significantly associated with excess alcohol intake, diabetes mellitus or human immunodeficiency virus; 80.0% treated with enzyme supplements reported symptomatic benefit with no difference in response between high and low dose supplementation (p=0.761). Conclusion: Targeting the use of FEL-1 in individuals with specific symptoms and associated conditions can lead to improved recognition of pancreatic exocrine insufficiency in a significant proportion of secondary care patients. Intervening with lifestyle advice such as smoking cessation and minimising alcohol intake could improve outcomes. In addition, up to 80% of patients with low faecal elastase respond to supplementation. Abbreviations: CFA: coefficient of fat absorption; CP: chronic pancreatitis; ELISA: enzyme-linked immune-absorbent assay; PEI: pancreatic exocrine insufficiency; FEL-1: faecal elastase-1; HIV: human immunodeficiency virus; IBD: inflammatory bowel disease; IBS: irritable bowel syndrome; PERT: pancreatic enzyme replacement therapy.

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The prevalence of fat-soluble vitamin deficiencies and a decreased bone mass in patients with chronic pancreatitis

Cited by 170 publications

References 39 publications

Clinical, anthropometric and laboratory nutritional markers of pancreatic exocrine insufficiency: Prevalence and diagnostic use

Clinical, anthropometric and laboratory nutritional markers of pancreatic exocrine insufficiency: Prevalence and diagnostic use

Anti-Inflammatory Actions of Vitamin K

Should we Investigate Gastroenterology Patients for Pancreatic Exocrine Insufficiency? A Dual Centre UK Study

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