Girish B N, Rajesh G, Vaidyanathan K, Balakrishnan V
Trop Gastroenterol. 2016 Jan-Mar;37(1):19-26.
The role of trace elements in the maintenance of normal pancreatic function is unclear.
To estimate trace elements (zinc and copper) in chronic pancreatitis (CP) patients and study their relationship with exocrine and endocrine insufficiency. Methods: The study involved 101 CP patients and 113 healthy controls. Disease characteristics and imaging features were recorded. Erythrocyte zinc (Zn) and copper (Cu) were estimated by flame atomic absorption spectrophotometry. Fecal pancreatic elastase1 was estimated by polyclonal antibody ELISA method as a marker of pancreatic exocrine function.
The mean erythrocyte Zn level and Zn/Cu ratio were significantly lower whereas the copper level was significantly higher in CP patients than controls. The mean Zn level and Zn/Cu ratio was significantly lower in CP patients with diabetes and those with low elastase1 as compared to non-diabetics and those with normal elastase1 respectively. Erythrocyte Cu level was significantly higher in CP patients with diabetes and with low elastase1 than those without diabetes and with normal elastase1 levels respectively. There was a significant positive correlation between elastase1 and Zn/Cu ratio (r = 0.396, p < 0.001). Receiver operating characteristic curve (ROC) analysis was performed to predict the development of exocrine insufficiency and it indicated an area under curve (AUC) of 0.838 ± 0.047 (95% CI: 0.746-0.93). The optimal cutoff value was 9.03 (sensitivity 86.5%, specificity 73.5%). When the same was performed to predict the development of diabetes, the AUC was 0.710 ± 0.05 (95% CI: 0.607-0.812). The optimal cutoff value was 7.2 (sensitivity 69.1%, specificity 69.7%).
Low erythrocyte Zn/Cu ratio was found to be associated with exocrine and endocrine insufficiency in CP patients.
微量元素在维持正常胰腺功能中的作用尚不清楚。
评估慢性胰腺炎（CP）患者体内的微量元素（锌和铜），并研究它们与外分泌和内分泌功能不全的关系。方法：该研究纳入了101例CP患者和113名健康对照者。记录疾病特征和影像学特征。采用火焰原子吸收分光光度法测定红细胞锌（Zn）和铜（Cu）。采用多克隆抗体ELISA法测定粪便胰弹性蛋白酶1，作为胰腺外分泌功能的标志物。
CP患者的平均红细胞锌水平和锌/铜比值显著低于对照组，而铜水平显著高于对照组。与非糖尿病患者和弹性蛋白酶1正常的患者相比，糖尿病CP患者和弹性蛋白酶1水平低的患者的平均锌水平和锌/铜比值分别显著降低。糖尿病CP患者和弹性蛋白酶1水平低的患者的红细胞铜水平分别显著高于无糖尿病和弹性蛋白酶1水平正常的患者。弹性蛋白酶1与锌/铜比值之间存在显著正相关（r = 0.396，p < 0.001）。进行受试者工作特征曲线（ROC）分析以预测外分泌功能不全的发生，结果显示曲线下面积（AUC）为0.838±0.047（95%CI：0.746 - 0.93）。最佳截断值为9.03（敏感性86.5%，特异性73.5%）。当进行同样分析以预测糖尿病的发生时，AUC为0.710±0.05（95%CI：0.607 - 0.812）。最佳截断值为7.2（敏感性69.1%，特异性69.7%）。
发现红细胞锌/铜比值低与CP患者的外分泌和内分泌功能不全有关。
