Schrader Henning, Menge Bjoern A, Belyaev Orlin, Uhl Waldemar, Schmidt Wolfgang E, Meier Juris J
Department of Medicine I, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.
Pancreas. 2009 May;38(4):416-21. doi: 10.1097/MPA.0b013e318194fc7a.
Chronic pancreatitis (CP) and pancreatic cancer (CA) have been associated with intestinal malabsorption and inflammation. However, little is known about the changes in amino acid metabolism in such patients.
The circulating amino acid levels were determined in 12 patients with CP, 12 CA patients, and 12 controls.
Total amino acid concentrations were 2850 +/- 71 micromol/L in controls, 2640 +/- 96 micromol/L in CP patients, and 2210 +/- 123 micromol/L in CA patients (P < 0.001). In CP patients, significant reductions in the concentrations of citrulline, gamma-aminobutyric acid, taurine, and aspartic acid were found (P < 0.05), whereas in CA patients, the levels of phosphoethanolamine, gamma-aminobutyric acid, aspartic acid, taurine, arginine, threonine, alanine, citrulline, and tryptophan were reduced. There was a significant inverse relationship between the total amino acid levels and the white blood cell counts (r = -0.44, P = 0.008).
Both patients with CP and with CA exhibit alterations in amino acid levels. The mechanisms underlying these defects may involve intestinal malabsorption as well as systemic inflammation. Providing selective amino acid supplementation to such patients may minimize the excess morbidity and mortality associated with protein malnutrition.
慢性胰腺炎（CP）和胰腺癌（CA）与肠道吸收不良及炎症相关。然而，此类患者氨基酸代谢的变化鲜为人知。
测定了12例CP患者、12例CA患者及12例对照者的循环氨基酸水平。
对照组总氨基酸浓度为2850±71微摩尔/升，CP患者为2640±96微摩尔/升，CA患者为2210±123微摩尔/升（P<0.001）。CP患者中，瓜氨酸、γ-氨基丁酸、牛磺酸和天冬氨酸浓度显著降低（P<0.05），而CA患者中，磷酸乙醇胺、γ-氨基丁酸、天冬氨酸、牛磺酸、精氨酸、苏氨酸、丙氨酸、瓜氨酸和色氨酸水平降低。总氨基酸水平与白细胞计数之间存在显著负相关（r = -0.44，P = 0.008）。
CP患者和CA患者均表现出氨基酸水平的改变。这些缺陷背后的机制可能涉及肠道吸收不良以及全身炎症。为此类患者提供选择性氨基酸补充剂可能会将与蛋白质营养不良相关的额外发病率和死亡率降至最低。
