Yield of testing for micronutrient deficiencies associated with pancreatic exocrine insufficiency in a clinical setting: An observational study  

作　　者：Mustafa Jalal Jennifer Anne Campbell Solomon Tesfaye Ahmed Al-Mukhtar Andrew Derek Hopper 

机构地区：[1]Academic Department of Gastroenterology,Sheffield Teaching Hospitals,Sheffield S102JF,United Kingdom [2]Department of Infection,Immunology and Cardiovascular disease,University of Sheffield,Sheffield S102TN,United Kingdom [3]Academic Unit of Diabetes and Endocrinology,Sheffield Teaching Hospitals,Sheffield S102JF,United Kingdom [4]Department of Surgery,Sheffield Teaching Hospitals,Sheffield S102JF,United Kingdom

出　　处：《World Journal of Clinical Cases》2021年第36期11320-11329,共10页世界临床病例杂志

摘　　要：BACKGROUND Pancreatic exocrine insufficiency(PEI)can be difficult to diagnose and causes maldigestion symptoms and malabsorption.There has been a number of studies that have identified PEI associated micronutrient deficiencies(PEI-MD),however there is variation in both the frequency and type of PEI-MD reported,with the majority of studies including patients with PEI due to chronic pancreatitis(CP)or CP without PEI.There is a paucity of information regarding the prevalence of PEIMD in patients with PEI without CP and the yield of testing for PEI-MD in a clinical setting in patients with suspected benign pancreatic diseases.AIM To prospectively assess the yield and type of PEI–MD in patients with and without PEI secondary to benign pancreatic disease.METHODS Patients investigated for maldigestion symptoms with Faecal Elastase-1(FEL-1)and suspected or proven benign pancreatic disease were prospectively identified.At the time of FEL-1 testing,serum samples were taken for micronutrients identified by previous studies as PEI-MD:prealbumin,retinol binding protein,copper,zinc,selenium,magnesium and later in the study lipid adjusted vitamin E.FEL-1 was recorded,with a result<200μg/g considered diagnostic of PEI.Patients underwent computed tomography(CT)imaging when there was a clinical suspicion of CP,a new diagnosis of PEI recurrent,pancreatic type pain(epigastric abdominal pain radiating to back with or without previous acute pancreatitis attacks)or weight loss.RESULTS After exclusions,112 patients were recruited that underwent testing for FEL-1 and PEI-MD.PEI was identified in 41/112(36.6%)patients and a pancreatic CT was performed in 82 patients.Overall a PEI-MD was identified in 21/112(18.8%)patients.The yield of PEI-MD was 17/41(41.5%)if PEI was present which was significantly higher than those without 4/71(5.6%)(P=0.0001).The yield of PEI–MD was significantly higher when PEI and CP were seen together 13/22(59.1%)compared to CP without PEI and PEI without CP(P<0.03).Individual micronutrient assessment showed a

关 键 词：Pancreatic exocrine insufficiency Chronic pancreatitis MICRONUTRIENT MALNUTRITION MALABSORPTION Nutritional markers 

分 类 号：R576[医药卫生—消化系统]