Teichmann J, Riemann J F, Lange U
Department of Gastroenterology, Endocrinology, and Diabetology, Klinikum Lüdenscheid, 58515 Lüdenscheid, Germany.
ISRN Gastroenterol. 2011;2011:951686. doi: 10.5402/2011/951686. Epub 2011 Nov 3.
Background. Previous research on the combined association of 25-hydroxyvitamin D [25(OH)D] and exocrine pancreas insufficiency may have been limited by restricted age variability and a lack of representation of both body weight and body mass index. There are still too few conclusive reports about conspicuous vitamin D metabolism according to pancreatic fecal elastase 1 (FE1) in obese patients. Methods. Between May 2004 and July 2008, we investigated in 125 female patients with obesity syndrome at an average age of approximately 52.9 years as well as in age-matched 80 healthy female controls the prevalence of pancreas insufficiency. Serum levels of PTH, total calcium, and D(3) vitamins calcitriol and calcifediol, as well as the concentration of fecal elastase 1 (FE1) were determined in patients and controls. Results. In 75 female nondiabetic patients with obesity syndrome (BMI 35 ≤ 40 kg/m(2)), calcifediol was markedly decreased (25.0 ± 4.9 ng/mL) compared to controls (50.2 ± 14.7 nmol/L; P < 0.01). FE1 level was significantly decreased in obese subjects compared to controls ( P < 0.01). Calcifediol was significantly lower in patients with morbid obesity (for calcifediol, P < 0.05). Conclusion. In obese females, pancreatic FE1 in feces confirms the extent of vitamin D supply, and thus shows a vitamin D(3) deficiency, depending on the loss of stool content. There seems to be a connection between the loss of exocrine function and the increasing body mass index. Pancreas insufficiency, as detected by low FE1 concentrations, is frequent in obese patients. However, the BMI is an additional factor for lowered fecal excretion of FE1.
背景。先前关于25-羟维生素D[25(OH)D]与外分泌胰腺功能不全联合关联的研究可能受到年龄变异性受限以及体重和体重指数缺乏代表性的限制。关于肥胖患者中根据胰腺粪便弹性蛋白酶1(FE1)的显著维生素D代谢的结论性报告仍然太少。方法。在2004年5月至2008年7月期间，我们调查了125名平均年龄约为52.9岁的肥胖综合征女性患者以及80名年龄匹配的健康女性对照者胰腺功能不全的患病率。测定了患者和对照者的血清甲状旁腺激素、总钙、D(3)维生素骨化三醇和骨化二醇水平以及粪便弹性蛋白酶1(FE1)的浓度。结果。在75名肥胖综合征非糖尿病女性患者(BMI 35≤40 kg/m(2))中，骨化二醇明显低于对照组(25.0±4.9 ng/mL对50.2±14.7 nmol/L；P<0.01)。肥胖受试者的FE1水平明显低于对照组(P<0.01)。病态肥胖患者的骨化二醇明显更低(对于骨化二醇，P<0.05)。结论。在肥胖女性中，粪便中的胰腺FE1证实了维生素D供应的程度，因此显示出维生素D(3)缺乏，这取决于粪便含量的流失。外分泌功能丧失与体重指数增加之间似乎存在联系。通过低FE1浓度检测到的胰腺功能不全在肥胖患者中很常见。然而，BMI是FE1粪便排泄降低的另一个因素。
