Deficiency of fat-soluble vitamins in chronic pancreatitis: A systematic review and meta-analysis.
BACKGROUND AND AIMSChronic pancreatitis (CP) patients are at risk for fat-soluble vitamins (A, D, E, K) deficiency, but available studies are small and heterogeneous. We conducted a systematic review and meta-analysis to determine the prevalence of fat-soluble vitamins deficiency in CP patients.
METHODSMedline was searched up to January 2016 for case series and case-control studies reporting prevalence of fat-soluble vitamin deficiency in CP patients. The prevalent deficiency rate was pooled for included studies, and deficiency rate between CP and controls, with relative odds ratio (OR) and 95% confidence interval (CI) calculated for case-control studies.
RESULTSTwelve studies including 548 patients included. With a random-effect model, the pooled prevalence rate of vitamin A, D and E deficiency were 16.8% (95%CI 6.9-35.7), 57.6% (95%CI 43.9-70.4) and 29.2% (95%CI 8.6-64.5) respectively, with considerable heterogeneity (I2 = 75%, 87.1% and 92%). Only one study evaluated vitamin K deficiency. The pooled OR for vitamin D deficiency in CP cases compared with controls was 1.17 (95% CI 0.77-1.78). Sensitivity analyses showed lower prevalence of vitamin A and E, and higher prevalence of vitamin D deficiency in high-quality studies. The rate of pancreatic exocrine insufficiency did not seem affect the deficiency rates, while the use of different cut-offs influences results and heterogeneity for vitamin E, but not A.
CONCLUSIONSFat-soluble vitamins deficiency is frequent in CP patients, with considerable heterogeneity. There is, however, no apparent increased risk of vitamin D deficiency in CP compared to controls. Larger, high-quality studies are necessary to better estimate the prevalence of fat-soluble vitamins deficiency, including vitamin K.
Gastroenterology Department, Hospital Universitario Cruces, Barakaldo-Bizkaia, Spain.,
Digestive & Liver Disease Unit, S. Andrea Hospital, University "Sapienza", Rome, Italy.,
Karolinska University Hospital, Sweden.,
Department of Digestive Tract Diseases, University Hospital, Lodz, Poland.,
Department of Endocrinology and Gastroenterology, Tartu University Hospital, University of Tartu, Estonia.,
Department for Internal Medicine I, University Hospital Regensburg, Germany.,
Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.,
Department of Medicine A, Ernst-Moritz-Arndt-University Greifswald, Germany.
Digestive & Liver Disease Unit, S. Andrea Hospital, University "Sapienza", Rome, Italy. Electronic address: email@example.com.
Vitamin A Deficiency
Vitamin D Deficiency
Vitamin E Deficiency
Vitamin K Deficiency
Pub Type(s)Journal Article