TY - JOUR
T1 - Micronutrient deficits in patients with chronic pancreatitis
T2 - prevalence, risk factors and pitfalls
AU - Jøker-Jensen, Henriette
AU - Mathiasen, Anne Sofie
AU - Køhler, Marianne
AU - Rasmussen, Henrik Højgaard
AU - Drewes, Asbjørn Mohr
AU - Olesen, Søren Schou
PY - 2020/10
Y1 - 2020/10
N2 - OBJECTIVE: We investigated the prevalence of micronutrient deficiencies and associated patient and disease-related risk factors in patients with chronic pancreatitis (CP).METHODS: We enrolled 115 consecutive CP outpatients. Micro-nutritional assessments included plasma levels of fat-soluble vitamins (A, D and E) and trace elements (magnesium and zinc). Bioelectrical impedance and muscle function tests were used to characterize the macro-nutritional status (sarcopenia and phase angle). Prevalence of micro-nutritional deficiencies was estimated and associated with a number of patient and disease characteristics including presence of exocrine pancreatic insufficiency (EPI) and diabetes mellitus. In an additional analysis, we explored the association between micronutrient levels and macro-nutritional status.RESULTS: The mean age of patients was 57.9 ± 13.0 years, 71% were men and 50% had an alcoholic aetiology. Vitamin D deficiency (22%) was the most common micronutrient deficit followed by zinc deficiency (20%) and magnesium deficiency (17%). Vitamin A deficiency (10%) and vitamin E deficiency (7%) were only seen in patients with EPI (P ≤ 0.03), while the presence of trace element deficits was associated with plasma albumin levels (P ≤ 0.006). Plasma zinc levels were decreased in sarcopenic patients (P < 0.001) and positively correlated to phase angle (coefficient 0.28; P < 0.001).CONCLUSION: Various micronutrient deficits were observed in CP outpatients, and associated risk factors were diverse and distinct for the individual nutrients. Taken together, our findings highlight the complexity of micronutrient assessment in patients with CP and emphasise the importance of simultaneous evaluation of plasma protein levels, inflammatory activity and macro-nutritional status.
AB - OBJECTIVE: We investigated the prevalence of micronutrient deficiencies and associated patient and disease-related risk factors in patients with chronic pancreatitis (CP).METHODS: We enrolled 115 consecutive CP outpatients. Micro-nutritional assessments included plasma levels of fat-soluble vitamins (A, D and E) and trace elements (magnesium and zinc). Bioelectrical impedance and muscle function tests were used to characterize the macro-nutritional status (sarcopenia and phase angle). Prevalence of micro-nutritional deficiencies was estimated and associated with a number of patient and disease characteristics including presence of exocrine pancreatic insufficiency (EPI) and diabetes mellitus. In an additional analysis, we explored the association between micronutrient levels and macro-nutritional status.RESULTS: The mean age of patients was 57.9 ± 13.0 years, 71% were men and 50% had an alcoholic aetiology. Vitamin D deficiency (22%) was the most common micronutrient deficit followed by zinc deficiency (20%) and magnesium deficiency (17%). Vitamin A deficiency (10%) and vitamin E deficiency (7%) were only seen in patients with EPI (P ≤ 0.03), while the presence of trace element deficits was associated with plasma albumin levels (P ≤ 0.006). Plasma zinc levels were decreased in sarcopenic patients (P < 0.001) and positively correlated to phase angle (coefficient 0.28; P < 0.001).CONCLUSION: Various micronutrient deficits were observed in CP outpatients, and associated risk factors were diverse and distinct for the individual nutrients. Taken together, our findings highlight the complexity of micronutrient assessment in patients with CP and emphasise the importance of simultaneous evaluation of plasma protein levels, inflammatory activity and macro-nutritional status.
KW - BMI
KW - albumin
KW - chronic pancreatitis
KW - exocrine pancreatic insufficiency
KW - micronutrients
KW - phase angle
KW - sarcopenia
UR - http://www.scopus.com/inward/record.url?scp=85090036806&partnerID=8YFLogxK
U2 - 10.1097/MEG.0000000000001866
DO - 10.1097/MEG.0000000000001866
M3 - Journal article
C2 - 32732813
SN - 0954-691X
VL - 32
SP - 1328
EP - 1334
JO - European Journal of Gastroenterology and Hepatology
JF - European Journal of Gastroenterology and Hepatology
IS - 10
ER -