Vitamin D Status and Per-oral Vitamin D Supplementation in Patients Suffering from Chronic Pancreatitis and Pancreatic Cancer Disease
Anticancer Research,  Clinical Article

Klapdor R et al. – The results demonstrate that vitamin D deficiency is a common problem in patients suffering from exocrine pancreatic insufficiency from various reasons as well as in the controls. Apart from insufficient sun exposure, exocrine pancreatic insufficiency, as well as a too low vitamin D uptake with food seem to represent the main causes of low serum 25(OH)D. In nearly all patients, the serum 25(OH)D concentrations could be normalized by oral supplementation of vitamin D in the case of individual therapy based on routine serum controls.

Methods
  • In all, 248 ambulatory patients (n=140 patients suffering from exocrine pancreatic insufficiency due to chronic pancreatitis, pancreatic cancer with/without previous resections of the pancreas n=108 patients without pancreatic disease), the authors measured the serum 25(OH)D concentrations by the chemoluminescence method.
  • In addition, in 91 of these patients (n=65 pancreatic patients, n=26 controls), they started supplementation with oral vitamin D in combination with dietary advice and adequate substitution with pancreatic enzyme preparations, followed by subsequent serum 25(OH)D determinations.
  • The oral vitamin D doses varied from 1000 IU per day over 1× 20000 IU per week, or 2-3 times 20000 IU per week up to 20000 IU per day in single patients, depending on the underlying disease and the estimated degree of maldigestion/malassimilation.
  • In addition, in a pilot trial vitamins A and E were measured in the serum from 121 and 105 of these patients respectively (resp.) (HPLC method).

Results
  • Serum 25(OH)D concentrations were <30 ng/ml in 93% of the patients with pancreatic diseases,<20 ng/ml in 77.9%, <10 ng/ml in 32.1% and <4 ng/ml in 9.3%.
  • The results were comparable to those in patients suffering from chronic pancreatitis and those with pancreatic tumor disease, with or without a previous tumor resection (n=51 Whipple procedure, n=11 left resection, n=9 total duodeno-pancreatectomy).
  • Similar data were also found in the controls, only slightly higher.
  • In contrast to the vitamin D data, however, determination of vitamins A and E in the serum resulted in values within the normal range for the majority of the patients of both groups, suggesting a diminished vitamin D uptake as being at least one reason to explain the low serum vitamin D concentrations in the patients with pancreatic diseases.
  • Individual supplementation with oral vitamin D in all patients studied (n=91) resulted in an increase of the serum 25(OH)D concentrations into the normal range (14.2±5.8 up to 42.3±12 in controls, 11.9±7.4 up to 46.6±15.7 in patients with pancreatic diseases).
  • The data of a subgroup of patients with continuous long-term supplementation, however, suggest that some patients with pancreatic diseases may need a significantly higher vitamin D supplementation, up to 20000 IU per day in single patients, compared to the controls.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Family Medicine

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Family Medicine Articles

1 A comparison of different oral therapies versus no treatment for erectile dysfunction in 196 radical nerve-sparing radical prostatectomy patients International Journal of Impotence Research: The Journal of Sexual Medicine, August 12, 2014    Clinical Article

2 Plasma tocopherols and risk of prostate cancer in the selenium and vitamin E cancer prevention trial (SELECT) Cancer Prevention Research, August 25, 2014    Clinical Article

3 Adjuvant radiotherapy versus wait-and-see after radical prostatectomy: 10-year follow-up of the ARO 96–02/AUO AP 09/95 Trial Full Text European Urology, July 18, 2014    Free full text    Clinical Article

4 Metformin in chemotherapy-naive castration-resistant prostate cancer: A multicenter phase 2 trial (SAKK 08/09) Full Text European Urology, August 15, 2014    Free full text    Clinical Article

5 Obesity is a risk factor for significant carotid atherosclerosis in patients aged 39 to 55 years Angiology, July 18, 2014    Evidence Based Medicine    Clinical Article

6 Management of prostate cancer in older patients: updated recommendations of a working group of the International Society of Geriatric Oncology The Lancet Oncology, July 30, 2014    Clinical Article

7 Circumcision plus antibiotic, anti-inflammatory, and α-blocker therapy for the treatment for chronic prostatitis/chronic pelvic pain syndrome: A prospective, randomized, multicenter trial World Journal of Urology, July 16, 2014    Clinical Article

8 Effect of caffeine on exercise capacity and function in prostate cancer survivors Medicine and Science in Sports and Exercise, July 9, 2014    Clinical Article

9 Urinating standing versus sitting: Position is of influence in men with prostate enlargement. A systematic review and meta-analysis PLOS ONE, August 1, 2014    Evidence Based Medicine    Review Article
Exclusive Author Commentary

10 Curcumin for the treatment of major depression: A randomised, double-blind, placebo controlled study Journal of Affective Disorders, July 16, 2014    Clinical Article

11 National trends in the management of low- and intermediate-risk prostate cancer in the United States The Journal of Urology, August 13, 2014    Clinical Article

12 Changes in circulating leptin levels during acute stress and associations with craving in abstinent smokers: A preliminary investigation Psychoneuroendocrinology, June 20, 2014    Clinical Article

13 Screening for prostate cancer in the US? Reduce the harms and keep the benefit International Journal of Cancer, August 15, 2014    Clinical Article

14 Effects of medical therapy or surgery on prostatic and bladder resistive indices in patients with benign prostatic hyperplasia Urologia Internationalis, August 19, 2014    Clinical Article

15 Management options for the treatment of benign prostatic hyperplasia with or without erectile dysfunction: a focus on tadalafil and patient considerations Full Text International Journal of General Medicine, August 12, 2014    Free full text    Review Article

16 Effects of tadalafil once daily or on demand versus placebo on time to recovery of erectile function in patients after bilateral nerve-sparing radical prostatectomy World Journal of Urology, August 27, 2014    Clinical Article

17 Cost-effectiveness of magnetic resonance (MR) imaging and MR-guided targeted biopsy versus systematic transrectal ultrasound–guided biopsy in diagnosing prostate cancer: A modelling study from a health care perspective Full Text European Urology, August 18, 2014    Free full text    Clinical Article

18 Radiation-induced secondary malignancy in prostate cancer: A systematic review and meta-analysis Urologia Internationalis, August 19, 2014    Evidence Based Medicine    Review Article

19 Efficacy of vilazodone on anxiety symptoms in patients with major depressive disorder International Clinical Psychopharmacology, July 2, 2014    Clinical Article

20 A population-based nested case-control study: the use of 5-alpha-reductase inhibitors and the increased risk of osteoporosis diagnosis in patients with benign prostate hyperplasia Clinical Endocrinology, August 28, 2014    Clinical Article

Indexed Journals in Family Medicine: American Family Physician, Archives of Family Med, Annals of Family Medmore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close