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Serum nutritional markers for prediction of pancreatic exocrine insufficiency in chronic pancreatitis.
Pancreatology. 2012 Jul-Aug; 12(4):305-10.P

Abstract

BACKGROUND

Methods for evaluation of pancreatic exocrine insufficiency (PEI) are expensive, labor intensive, and not available at many institutions. The aim of this study was to investigate if PEI in chronic pancreatitis (CP) can by predicted by nutritional markers in blood.

METHODS

A retrospective analysis of a prospectively collected database of CP patients was performed. Diagnosis of CP was based on endoscopic ultrasonography or magnetic resonance imaging. PEI was investigated by the (13)C-mixed triglyceride breath test. Hemoglobin, mean corpuscular volume, lymphocytes, prothrombin time, and serum levels of total protein, albumin, prealbumin, retinol binding protein, cholesterol, triglycerides, amylase, folic acid, vitamin B12, HbA1C, transferrin, ferritin, magnesium and zinc were analyzed.

RESULTS

114 patients were included in the study (97 males, mean age 48.1 years, 54 with alcohol etiology), 38 (33%) suffered from PEI. Magnesium below 2.05 mg/dL, hemoglobin, albumin, prealbumin and retinol binding protein below lower limit of normal and HbA1C above upper limit of normal were associated with PEI in univariate analysis. Magnesium below 2.05 mg/dL detected PEI with a sensitivity, specificity and positive and negative predictive values of 0.88 (95% confidence interval, 0.66-0.97), 0.66 (0.48-0.80), 0.58 (0.39-0.75) and 0.91 (0.73-0.98), respectively. The corresponding values were 1.00 (0.80-1.00), 0.55 (0.38-0.71), 0.52 (0.34-0.69) and 1.00 (0.82-1.00)) if one or more pathological tests among parameters significantly associated with PEI in was used as a positive test for PEI.

CONCLUSION

Serum nutritional markers can be used to predict the probability of PEI in CP and provide guidance in decisions on enzyme replacement therapy.

Authors+Show Affiliations

Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22898630

Citation

Lindkvist, Björn, et al. "Serum Nutritional Markers for Prediction of Pancreatic Exocrine Insufficiency in Chronic Pancreatitis." Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.], vol. 12, no. 4, 2012, pp. 305-10.
Lindkvist B, Domínguez-Muñoz JE, Luaces-Regueira M, et al. Serum nutritional markers for prediction of pancreatic exocrine insufficiency in chronic pancreatitis. Pancreatology. 2012;12(4):305-10.
Lindkvist, B., Domínguez-Muñoz, J. E., Luaces-Regueira, M., Castiñeiras-Alvariño, M., Nieto-Garcia, L., & Iglesias-Garcia, J. (2012). Serum nutritional markers for prediction of pancreatic exocrine insufficiency in chronic pancreatitis. Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.], 12(4), 305-10. https://doi.org/10.1016/j.pan.2012.04.006
Lindkvist B, et al. Serum Nutritional Markers for Prediction of Pancreatic Exocrine Insufficiency in Chronic Pancreatitis. Pancreatology. 2012 Jul-Aug;12(4):305-10. PubMed PMID: 22898630.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum nutritional markers for prediction of pancreatic exocrine insufficiency in chronic pancreatitis. AU - Lindkvist,Björn, AU - Domínguez-Muñoz,J Enrique, AU - Luaces-Regueira,María, AU - Castiñeiras-Alvariño,Margarita, AU - Nieto-Garcia,Laura, AU - Iglesias-Garcia,Julio, Y1 - 2012/05/04/ PY - 2012/01/26/received PY - 2012/04/25/revised PY - 2012/04/26/accepted PY - 2012/8/18/entrez PY - 2012/8/18/pubmed PY - 2013/1/8/medline SP - 305 EP - 10 JF - Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] JO - Pancreatology VL - 12 IS - 4 N2 - BACKGROUND: Methods for evaluation of pancreatic exocrine insufficiency (PEI) are expensive, labor intensive, and not available at many institutions. The aim of this study was to investigate if PEI in chronic pancreatitis (CP) can by predicted by nutritional markers in blood. METHODS: A retrospective analysis of a prospectively collected database of CP patients was performed. Diagnosis of CP was based on endoscopic ultrasonography or magnetic resonance imaging. PEI was investigated by the (13)C-mixed triglyceride breath test. Hemoglobin, mean corpuscular volume, lymphocytes, prothrombin time, and serum levels of total protein, albumin, prealbumin, retinol binding protein, cholesterol, triglycerides, amylase, folic acid, vitamin B12, HbA1C, transferrin, ferritin, magnesium and zinc were analyzed. RESULTS: 114 patients were included in the study (97 males, mean age 48.1 years, 54 with alcohol etiology), 38 (33%) suffered from PEI. Magnesium below 2.05 mg/dL, hemoglobin, albumin, prealbumin and retinol binding protein below lower limit of normal and HbA1C above upper limit of normal were associated with PEI in univariate analysis. Magnesium below 2.05 mg/dL detected PEI with a sensitivity, specificity and positive and negative predictive values of 0.88 (95% confidence interval, 0.66-0.97), 0.66 (0.48-0.80), 0.58 (0.39-0.75) and 0.91 (0.73-0.98), respectively. The corresponding values were 1.00 (0.80-1.00), 0.55 (0.38-0.71), 0.52 (0.34-0.69) and 1.00 (0.82-1.00)) if one or more pathological tests among parameters significantly associated with PEI in was used as a positive test for PEI. CONCLUSION: Serum nutritional markers can be used to predict the probability of PEI in CP and provide guidance in decisions on enzyme replacement therapy. SN - 1424-3911 UR - https://www.unboundmedicine.com/medline/citation/22898630/Serum_nutritional_markers_for_prediction_of_pancreatic_exocrine_insufficiency_in_chronic_pancreatitis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1424-3903(12)00125-1 DB - PRIME DP - Unbound Medicine ER -