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 Oncology

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

Most Popular Oncology Articles

1 Randomized phase III trial of erlotinib versus docetaxel as second- or third-line therapy in patients with advanced non-small-cell lung cancer: Docetaxel and Erlotinib Lung Cancer Trial (DELTA) Journal of Clinical Oncology, May 29, 2014    Clinical Article

2 Ibrutinib versus ofatumumab in previously treated chronic lymphoid leukemia New England Journal of Medicine, June 4, 2014    Evidence Based Medicine    Clinical Article

3 Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials The Lancet, March 25, 2014    Evidence Based Medicine    Clinical Article

4 A randomised phase II study of pemetrexed versus pemetrexed+erlotinib as second-line treatment for locally advanced or metastatic non-squamous non-small cell lung cancer European Journal of Cancer, May 23, 2014    Clinical Article

5 Rituximab versus a watch-and-wait approach in patients with advanced-stage, asymptomatic, non-bulky follicular lymphoma: an open-label randomised phase 3 trial The Lancet Oncology, March 7, 2014    Clinical Article

6 Survival of women with inflammatory breast cancer: A large population based study Annals of Oncology, April 16, 2014    Clinical Article

7 Coffee intake and gastric cancer risk Cancer Epidemiology, Biomarkers & Prevention, March 20, 2014    Clinical Article

8 Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology Clinical Practice Guideline Journal of Clinical Oncology, May 5, 2014    Clinical Guideline

9 Panitumumab versus cetuximab in patients with chemotherapy-refractory wild-type KRAS exon 2 metastatic colorectal cancer (ASPECCT): a randomised, multicentre, open-label, non-inferiority phase 3 study The Lancet Oncology, May 27, 2014    Clinical Article

10 Radiotherapy of follicular lymphoma: updated role and new rules Current Treatment Options in Oncology, May 16, 2014    Clinical Guideline    Clinical Article

11 Adjuvant exemestane with ovarian suppression in premenopausal breast cancer New England Journal of Medicine, June 9, 2014    Evidence Based Medicine    Clinical Article

12 Everolimus for women with trastuzumab-resistant, HER2-positive, advanced breast cancer (BOLERO-3): a randomised, double-blind, placebo-controlled phase 3 trial The Lancet Oncology, May 27, 2014    Clinical Article

13 Open versus laparoscopic surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): survival outcomes of an open-label, non-inferiority, randomised controlled trial The Lancet Oncology, June 11, 2014    Clinical Article

14 Oral contraceptives, hormone replacement therapy and breast cancer risk: A cohort study of 16 928 women 48 years and older Acta Oncologica, May 22, 2014    Clinical Article

15 Resistance mechanisms for the Bruton's tyrosine kinase inhibitor ibrutinib New England Journal of Medicine, June 3, 2014    Evidence Based Medicine    Clinical Article

16 PEAK: A randomized, multicenter phase II study of panitumumab plus modified fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) or bevacizumab plus mFOLFOX6 in patients with previously untreated, unresectable, wild-type KRAS exon 2 metastatic colorectal cancer Journal of Clinical Oncology, May 9, 2014    Clinical Article

17 Exposure to infections and risk of leukemia in young children Cancer Epidemiology, Biomarkers & Prevention, May 6, 2014    Clinical Article

18 Underuse of trimodality treatment affects survival for patients with inflammatory breast cancer: an analysis of treatment and survival trends from the National Cancer Database Journal of Clinical Oncology, June 13, 2014    Clinical Article

19 Risk of late effects of treatment in children newly diagnosed with standard-risk acute lymphoblastic leukaemia: a report from the Childhood Cancer Survivor Study cohort The Lancet Oncology, June 20, 2014    Clinical Article

20 Coffee intake and gastric cancer risk Cancer Epidemiology, Biomarkers & Prevention, March 11, 2014    Clinical Article

Indexed Journals in Oncology: Journal of Clinical Oncology, Cancer Research, Annals Oncologymore

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