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.
► 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 Controlling obesity with potato extract McGill University News, December 11, 2014

2 Calcium and phosphorus intake and prostate cancer risk: A 24-y follow-up study American Journal of Clinical Nutrition, November 26, 2014    Clinical Article

3 Boiled coffee consumption and the risk of prostate cancer: follow-up of 224,234 Norwegian men 20-69 years British Journal of Cancer, December 24, 2014    Clinical Article

4 The use of aspirin and the risk of mortality in patients with prostate cancer The Journal of Urology, December 8, 2014    Clinical Article

5 Influence of metformin use on PSA values, free-to-total PSA, prostate cancer incidence and grade and overall survival in a prospective screening trial (ERSPC Aarau) World Journal of Urology, November 3, 2014    Clinical Article

6 Tea consumption and leukemia risk: A meta-analysis Tumor Biology, February 12, 2014    Evidence Based Medicine    Clinical Article

7 Tai chi as an alternative and complimentary therapy for anxiety: A systematic review Journal of Evidence-Based Complementary & Alternative Medicine, December 22, 2014    Evidence Based Medicine    Review Article

8 Dairy products, calcium, and prostate cancer risk: A systematic review and meta-analysis of cohort studies American Journal of Clinical Nutrition, November 26, 2014    Clinical Article

9 Crocin, the main active saffron constituent, as an adjunctive treatment in major depressive disorder: A randomized, double-blind, placebo-controlled, pilot clinical trial Journal of Affective Disorders, December 9, 2014    Clinical Article

10 Tea consumption and the risk of five major cancers: A dose-response meta-analysis of prospective studies Full Text BMC Cancer, March 18, 2014    Free full text    Evidence Based Medicine    Review Article

11 Dietary carrot consumption and the risk of prostate cancer European Journal of Nutrition, February 17, 2014    Clinical Article

12 Coffee consumption and prostate cancer risk: An updated meta-analysis Cancer Causes and Control, March 3, 2014    Evidence Based Medicine    Clinical Article

13 Systematic review of prostate cancer risk and association with consumption of fish and fish-oils: Analysis of 495,321 participants International Journal of Clinical Practice, December 16, 2014    Clinical Article

14 Impact of the 2012 United States preventive services task force statement on prostate-specific antigen screening: Analysis of urologic and primary care practices Urology, November 17, 2014    Clinical Article

15 Role of diet in prostate cancer: the epigenetic link Oncogene, December 24, 2014    Clinical Article

16 Associations of vitamin D pathway genes with circulating 25-hydroxyvitamin-D, 1,25-dihydroxyvitamin-D, and prostate cancer: A nested case-control study Cancer Causes and Control, December 10, 2014    Clinical Article

17 Time to onset of clinically meaningful improvement with tadalafil 5mg once daily in the treatment of men with lower urinary tract symptoms secondary to benign prostatic hyperplasia: analysis of data pooled from four pivotal, double-blind, placebo-controlled studies The Journal of Urology, December 1, 2014    Clinical Article

18 The obesity paradox in the US population Full Text American Journal of Clinical Nutrition, May 2, 2013    Free full text    Review Article

19 Prophylactic efficacy of fluoxetine, escitalopram, sertraline, paroxetine, and concomitant psychotherapy in major depressive disorder: Outcome after long-term follow-up Psychiatry Research, December 2, 2014    Clinical Article

20 Long-term coffee consumption and risk of cardiovascular disease Circulation, February 11, 2014    Evidence Based Medicine    Review Article    Clinical Article

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

Make smarter career moves with less time.

Sign up for our free job placement service today and have a dedicated career consultant help locate the right physician job for you!
Click Here for more information.

Get Started Now!

Free-of-charge, no obligation.

Terms and Conditions For M3 Career Consult

By registering with the M3 Career Consult service you authorize M3 USA Corporation to represent you in your job search. The following is a summary of the terms of our service and our mutual obligations to help you find a job:

  • You designate M3 to act as your agent and represent you in your job search;
  • You will not pay us for this service
  • You will advise us of any companies or positions to which you apply or have applied;
  • You will advise us if you believe you are not capable of performing a position for which we submit you, or for which you interview;
  • You will keep all information we provide you about companies or positions strictly confidential;
  • You will promptly provide us with information we request of you;
  • You will make yourself reasonably available for phone, video and in-person conversations and interviews;
  • You will be truthful in all of your communications with us; and
  • You will advise us if anything above changes.
 

The Top Read Articles of 2014 are Now Available

Scouring thousands of peer-reviewed journals and popular press, Our Editors just released the Top Read Articles of the Year. See the Top Read List