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Deficiency of fat-soluble vitamins in chronic pancreatitis: A systematic review and meta-analysis.
Pancreatology 2016 Nov - Dec; 16(6):988-994P

Abstract

BACKGROUND AND AIMS

Chronic 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.

METHODS

Medline 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.

RESULTS

Twelve 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.

CONCLUSIONS

Fat-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.

Authors+Show Affiliations

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: gabriele.capurso@gmail.com.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

27681502

Citation

Martínez-Moneo, Emma, et al. "Deficiency of Fat-soluble Vitamins in Chronic Pancreatitis: a Systematic Review and Meta-analysis." Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.], vol. 16, no. 6, 2016, pp. 988-994.
Martínez-Moneo E, Stigliano S, Hedström A, et al. Deficiency of fat-soluble vitamins in chronic pancreatitis: A systematic review and meta-analysis. Pancreatology. 2016;16(6):988-994.
Martínez-Moneo, E., Stigliano, S., Hedström, A., Kaczka, A., Malvik, M., Waldthaler, A., ... Capurso, G. (2016). Deficiency of fat-soluble vitamins in chronic pancreatitis: A systematic review and meta-analysis. Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.], 16(6), pp. 988-994. doi:10.1016/j.pan.2016.09.008.
Martínez-Moneo E, et al. Deficiency of Fat-soluble Vitamins in Chronic Pancreatitis: a Systematic Review and Meta-analysis. Pancreatology. 2016;16(6):988-994. PubMed PMID: 27681502.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Deficiency of fat-soluble vitamins in chronic pancreatitis: A systematic review and meta-analysis. AU - Martínez-Moneo,Emma, AU - Stigliano,Serena, AU - Hedström,Aleksandra, AU - Kaczka,Aleksandra, AU - Malvik,Marko, AU - Waldthaler,Alexander, AU - Maisonneuve,Patrick, AU - Simon,Peter, AU - Capurso,Gabriele, Y1 - 2016/09/20/ PY - 2016/07/12/received PY - 2016/09/08/revised PY - 2016/09/20/accepted PY - 2016/9/30/pubmed PY - 2017/4/5/medline PY - 2016/9/30/entrez KW - Chronic pancreatitis KW - Fat-soluble vitamins KW - Meta-analysis KW - Vitamin A KW - Vitamin D KW - Vitamin E KW - Vitamin K SP - 988 EP - 994 JF - Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] JO - Pancreatology VL - 16 IS - 6 N2 - BACKGROUND AND AIMS: Chronic 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. METHODS: Medline 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. RESULTS: Twelve 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. CONCLUSIONS: Fat-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. SN - 1424-3911 UR - https://www.unboundmedicine.com/medline/citation/27681502/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1424-3903(16)31205-4 DB - PRIME DP - Unbound Medicine ER -