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The prevalence of fat-soluble vitamin deficiencies and a decreased bone mass in patients with chronic pancreatitis.
Pancreatology. 2013 May-Jun; 13(3):238-42.P

Abstract

BACKGROUND/OBJECTIVES

In chronic pancreatitis, malabsorption of fat is common due to loss of exocrine function. Consequently, these patients are at risk to acquire deficiencies of the fat-soluble vitamins, which may result in a decreased bone mineral density (BMD) and the development of osteopenia and osteoporosis.

METHODS

We prospectively enrolled all patients diagnosed with chronic pancreatitis, who visited our outpatient clinic between March and November 2011. Data were collected regarding demographic characteristics, symptoms, and pancreatic function. Serum concentrations of vitamins A, E, K, and D were determined, and BMD was assessed by means of bone densitometry. Results were analyzed according to pancreatic function status and enzyme use, and compared to reference data, when available.

RESULTS

Forty patients were included (43% female; mean age of 52). Alcohol abuse was the major cause of pancreatitis (50%). Twenty-eight patients were exocrine insufficient (70%), of whom 19 used pancreatic enzymes. Vitamin A, D, E, and K deficiencies were present in 3, 53, 10, and 63% of patients, respectively. Osteopenia and osteoporosis were observed in 45% and 10% of patients. A decreased BMD was more frequently observed than expected, based on reference data, even in exocrine sufficient patients.

CONCLUSIONS

Deficiencies of fat-soluble vitamins and a decreased BMD are frequently present in chronic pancreatitis, even in exocrine sufficient patients. Consequently, all patients with chronic pancreatitis should be routinely screened for fat-soluble vitamin deficiencies and a decreased BMD.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands. e.sikkens@erasmusmc.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23719594

Citation

Sikkens, Edmée C M., et al. "The Prevalence of Fat-soluble Vitamin Deficiencies and a Decreased Bone Mass in Patients With Chronic Pancreatitis." Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.], vol. 13, no. 3, 2013, pp. 238-42.
Sikkens EC, Cahen DL, Koch AD, et al. The prevalence of fat-soluble vitamin deficiencies and a decreased bone mass in patients with chronic pancreatitis. Pancreatology. 2013;13(3):238-42.
Sikkens, E. C., Cahen, D. L., Koch, A. D., Braat, H., Poley, J. W., Kuipers, E. J., & Bruno, M. J. (2013). The prevalence of fat-soluble vitamin deficiencies and a decreased bone mass in patients with chronic pancreatitis. Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.], 13(3), 238-42. https://doi.org/10.1016/j.pan.2013.02.008
Sikkens EC, et al. The Prevalence of Fat-soluble Vitamin Deficiencies and a Decreased Bone Mass in Patients With Chronic Pancreatitis. Pancreatology. 2013 May-Jun;13(3):238-42. PubMed PMID: 23719594.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The prevalence of fat-soluble vitamin deficiencies and a decreased bone mass in patients with chronic pancreatitis. AU - Sikkens,Edmée C M, AU - Cahen,Djuna L, AU - Koch,Arjun D, AU - Braat,Henri, AU - Poley,Jan-Werner, AU - Kuipers,Ernst J, AU - Bruno,Marco J, Y1 - 2013/03/04/ PY - 2012/11/02/received PY - 2013/02/11/revised PY - 2013/02/14/accepted PY - 2013/5/31/entrez PY - 2013/5/31/pubmed PY - 2014/1/18/medline SP - 238 EP - 42 JF - Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] JO - Pancreatology VL - 13 IS - 3 N2 - BACKGROUND/OBJECTIVES: In chronic pancreatitis, malabsorption of fat is common due to loss of exocrine function. Consequently, these patients are at risk to acquire deficiencies of the fat-soluble vitamins, which may result in a decreased bone mineral density (BMD) and the development of osteopenia and osteoporosis. METHODS: We prospectively enrolled all patients diagnosed with chronic pancreatitis, who visited our outpatient clinic between March and November 2011. Data were collected regarding demographic characteristics, symptoms, and pancreatic function. Serum concentrations of vitamins A, E, K, and D were determined, and BMD was assessed by means of bone densitometry. Results were analyzed according to pancreatic function status and enzyme use, and compared to reference data, when available. RESULTS: Forty patients were included (43% female; mean age of 52). Alcohol abuse was the major cause of pancreatitis (50%). Twenty-eight patients were exocrine insufficient (70%), of whom 19 used pancreatic enzymes. Vitamin A, D, E, and K deficiencies were present in 3, 53, 10, and 63% of patients, respectively. Osteopenia and osteoporosis were observed in 45% and 10% of patients. A decreased BMD was more frequently observed than expected, based on reference data, even in exocrine sufficient patients. CONCLUSIONS: Deficiencies of fat-soluble vitamins and a decreased BMD are frequently present in chronic pancreatitis, even in exocrine sufficient patients. Consequently, all patients with chronic pancreatitis should be routinely screened for fat-soluble vitamin deficiencies and a decreased BMD. SN - 1424-3911 UR - https://www.unboundmedicine.com/medline/citation/23719594/The_prevalence_of_fat_soluble_vitamin_deficiencies_and_a_decreased_bone_mass_in_patients_with_chronic_pancreatitis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1424-3903(13)00043-4 DB - PRIME DP - Unbound Medicine ER -