Midha Shallu, Singh Namrata, Sachdev Vikas, Tandon Rakesh Kumar, Joshi Yogendra Kumar, Garg Pramod Kumar
Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
J Gastroenterol Hepatol. 2008 Sep;23(9):1378-83. doi: 10.1111/j.1440-1746.2008.05459.x. Epub 2008 Jun 28.
Patients with chronic pancreatitis are often malnourished. The role of malnutrition in the pathogenesis of chronic pancreatitis is unclear. The aim of the present article was to study prospectively the cause and effect relationship of malnutrition with idiopathic chronic pancreatitis in a case-control study.
Consecutive patients with chronic pancreatitis underwent anthropometry, nutritional and dietary assessments. For dietary assessment, food frequency questionnaire and 24-hour dietary recall methods were used. Primary outcome measure was cause and effect relationship of malnutrition with idiopathic chronic pancreatitis.
Of 201 patients with chronic pancreatitis, 120 had idiopathic chronic pancreatitis (mean age 29.60 years, 74 males) who formed the study group. None of the patients consumed cassava. The nutritional status and dietary intake of the patients before the onset of chronic pancreatitis were comparable with those of controls with 20.6% of patients and 22.5% of controls being malnourished (body mass index [BMI] < 18.5). After the onset of chronic pancreatitis, 56.5% of patients lost weight and significantly more patients became malnourished compared with controls (45.8% vs 22.5%; P < 0.001). The causes of weight loss were diabetes, higher calories from proteins, and pseudocyst.
Malnutrition was not a cause of idiopathic chronic pancreatitis and weight loss occurred as an effect of chronic pancreatitis. Cassava was not found to be a cause of idiopathic chronic pancreatitis.
慢性胰腺炎患者常伴有营养不良。营养不良在慢性胰腺炎发病机制中的作用尚不清楚。本文旨在通过病例对照研究前瞻性地探讨营养不良与特发性慢性胰腺炎之间的因果关系。
对连续性慢性胰腺炎患者进行人体测量、营养和饮食评估。饮食评估采用食物频率问卷和24小时饮食回顾法。主要观察指标是营养不良与特发性慢性胰腺炎之间的因果关系。
201例慢性胰腺炎患者中，120例为特发性慢性胰腺炎（平均年龄29.60岁，男性74例），构成研究组。所有患者均未食用木薯。慢性胰腺炎发病前患者的营养状况和饮食摄入量与对照组相当，20.6%的患者和22.5%的对照组存在营养不良（体重指数[BMI]<18.5）。慢性胰腺炎发病后，56.5%的患者体重减轻，与对照组相比，营养不良的患者显著增多（45.8%对22.5%；P<0.001）。体重减轻的原因是糖尿病、蛋白质热量摄入增加和假性囊肿。
营养不良不是特发性慢性胰腺炎的病因，体重减轻是慢性胰腺炎的结果。未发现木薯是特发性慢性胰腺炎的病因。
