RESUMEN
OBJECTIVES: Homocysteine has been implicated in vascular dysfunction and thrombosis, as well as inflammatory conditions. This study was aimed to find out whether chronic pancreatitis (CP) is associated with hyperhomocysteinemia and derangements of transmethylation and transsulfuration pathways. METHODS: We estimated homocysteine and its metabolites in 45 alcoholic CP patients, 45 tropical CP patients, and 48 healthy controls. RESULTS: Significant increases in plasma total homocysteine and decreases in red blood cell folate, reduced glutathione, plasma methionine, cysteine, and urinary inorganic sulfate/creatinine ratio were observed in both alcoholic and tropical CP patients in comparison with healthy controls. Red blood cell glutathione and plasma cysteine levels were significantly lower in alcoholic than in tropical CP patients. However, plasma vitamin B12 levels were comparable between CP patients and controls. No significant differences in these parameters were observed between diabetic patients and nondiabetic patients. Multivariate regression analysis showed a significant negative correlation between homocysteine and folate (r = -0.415, P = 0.001) and a positive correlation between glutathione and cysteine levels (r = 0.37, P = 0.003). CONCLUSIONS: Chronic pancreatitis is associated with hyperhomocysteinemia and derangements in transmethylation and transsulfuration pathways. Low folate levels observed in these patients seem to have a key role in this derangement.
Asunto(s)
Hiperhomocisteinemia/complicaciones , Pancreatitis Crónica/complicaciones , Transducción de Señal , Adulto , Creatinina/orina , Cisteína/sangre , Eritrocitos/metabolismo , Femenino , Ácido Fólico/sangre , Glutatión/sangre , Homocisteína/sangre , Humanos , Masculino , Metionina/sangre , Metilación , Persona de Mediana Edad , Modelos Biológicos , Análisis Multivariante , Pancreatitis Alcohólica/sangre , Pancreatitis Alcohólica/complicaciones , Pancreatitis Alcohólica/orina , Pancreatitis Crónica/sangre , Pancreatitis Crónica/orina , Análisis de Regresión , Sulfatos/orina , Azufre/metabolismo , Adulto JovenRESUMEN
BACKGROUND AND AIM: Recent surveys suggest a change in nutritional status of population in Kerala along with a steep rise in alcoholism. We aimed to conduct a comprehensive assessment of anthropometric, biochemical, clinical and dietary parameters and study the association of nutritional status with dietary intake. METHODS: We compared the nutrient intake of a cohort of patients with chronic pancreatitis with a recent population survey. We also sought to compare the prevalent nutritional status of patients with previous series. RESULTS: Chronic pancreatitis patients had poor intake of most nutrients. However, severe malnutrition is present only in a small minority (4%) as compared to previous series. Fat intake in patients with tropical chronic pancreatitis was significantly lower in alcoholic chronic pancreatitis patients (27.5 g/d vs. 43 g/d). CONCLUSIONS: Malnutrition remains an important problem in chronic pancreatitis; however severe malnutrition is rare as compared to previous series. Energy (calorie) deprivation and micronutrient deficiency are major nutritional issues. Use of additional anthropometric parameters, especially triceps skin fold thickness, in conjunction with body mass index, is helpful. Subjective global assessment is a useful method for assessment for nutritional status in chronic pancreatitis patients.