Segal I, Gut A, Schofield D, Shiel N, Braganza J M
Division of Gastroenterology, Baragwanath Hospital, Johannesburg, South Africa.
Clin Chim Acta. 1995 Jul 31;239(1):71-9. doi: 10.1016/0009-8981(95)06102-j.
Biochemical assessments of micronutrient antioxidant status were done in 14 consecutive black patients with calcific chronic pancreatitis and 15 controls at Soweto, near Johannesburg in southern Africa. The patients showed subnormal levels of vitamin C in plasma; selenium, beta-carotene and alpha-tocopherol in serum; and inorganic sulphate (as an index of long-term sulphur amino acid intake) in urine (P < 0.001 for each): furthermore, among the patients ascorbate constituted a lower fraction of vitamin C (P < 0.002), indicating heightened oxidation of the bioactive form. By comparing the results in Sowetan controls with reference ranges from Manchester, UK, the markedly lower vitamin C and, hence, ascorbate levels in the Sowetans was underlined (P < 0.001) and their selenium levels were also lower (P < 0.001), but beta-carotene, alpha-tocopherol and inorganic sulphate levels were comparable. The very low bioavailability of ascorbate among Sowetan controls is reminiscent of our previous finding in outwardly healthy people at Madras in southern India: in both these areas chronic pancreatitis is currently endemic, has a propensity to pancreatic calculi and runs a virulent course towards premature death from diabetes, malnutrition or pancreatic cancer. Considering that low ascorbate levels are a feature in patients with chronic pancreatitis who develop pancreatic calculi at Manchester and that antioxidant supplements ameliorate painful symptoms, we suggest that poor antioxidant intake may predispose underprivileged tropical communities to the disease. If so, there could be an opportunity for prophylaxis through a daily tablet containing vitamin C, perhaps along with selenium at Soweto and beta-carotene at Madras.
在非洲南部约翰内斯堡附近索韦托，对14例连续性钙化性慢性胰腺炎黑人患者及15名对照者进行了微量营养素抗氧化状态的生化评估。患者血浆中维生素C水平低于正常；血清中硒、β-胡萝卜素和α-生育酚水平低于正常；尿中无机硫酸盐（作为长期硫氨基酸摄入量的指标）水平低于正常（每项P<0.001）：此外，患者中抗坏血酸盐占维生素C的比例较低（P<0.002），表明生物活性形式的氧化增强。通过将索韦托对照者的结果与英国曼彻斯特的参考范围进行比较，突出显示了索韦托人维生素C水平明显较低，因此抗坏血酸盐水平也较低（P<0.001），他们的硒水平也较低（P<0.001），但β-胡萝卜素、α-生育酚和无机硫酸盐水平相当。索韦托对照者中抗坏血酸盐的生物利用率极低，这让人想起我们之前在印度南部马德拉斯外表健康的人群中的发现：在这两个地区，慢性胰腺炎目前都是地方病，易患胰腺结石，并且会因糖尿病、营养不良或胰腺癌而导致过早死亡。鉴于在曼彻斯特，低抗坏血酸盐水平是患有胰腺结石的慢性胰腺炎患者的一个特征，并且抗氧化剂补充剂可缓解疼痛症状，我们认为抗氧化剂摄入不足可能使贫困的热带社区易患这种疾病。如果是这样，那么有可能通过每日服用一片含维生素C的药片进行预防，在索韦托或许还可加服硒，在马德拉斯加服β-胡萝卜素。
