Carroccio A, Iacono G, Montalto G, Cavataio F, Lorello D, Soresi M, Di Martino D, Notarbartolo A
Cattedra di Medicina Interna, Università di Palermo, Italy.
Dig Dis Sci. 1994 Oct;39(10):2235-42. doi: 10.1007/BF02090377.
To determine the relationship between pancreatic secretory capacity and nutritional status in celiac patients, we studied 52 patients with celiac disease (24 males, 28 females; age range 6-36 months) and 30 healthy control subjects (14 males, 16 females; age range 6-42 months). A secretin-cerulein test was performed on all patients, and levels of serum albumin and plasma fibronectin were assayed. In addition, weight/height ratios were calculated in the celiacs, who were then divided into three groups on this basis, as follows: celiacs with weight/height ratio < or = 3rd percentile; those with weight/height ratio between the 4th and 10th percentiles; and those with weight/height ratio > 10th percentile. There was no significant difference in the duodenal output of chymotrypsin, phospholipase and lipase between these groups. When the total celiac group was compared to control subjects, only lipase levels were significantly lower (P < 0.009). However, subnormal values in one or more pancreatic enzymes were observed in 15/52 celiacs (29%). A residual enzyme activity < 10% of normal secretory capacity, was also found in 4/52 patients. There was no correlation between the output of the various pancreatic enzymes and levels of albumin, fibronectin, and weight/height ratios in the patients. Furthermore, there was no difference in weight/height ratios and levels of albumin and fibronectin between the celiac subjects with pancreatic deficiency and those with normal pancreatic function. We conclude that a mild/moderate pancreatic insufficiency is quite frequent in celiacs, but that it may be completely independent of nutritional status; further studies are therefore required to shed light on its pathogenesis.
为了确定乳糜泻患者胰腺分泌能力与营养状况之间的关系，我们研究了52例乳糜泻患者（24例男性，28例女性；年龄范围6 - 36个月）和30例健康对照者（14例男性，16例女性；年龄范围6 - 42个月）。对所有患者进行了促胰液素 - 胰酶泌素试验，并检测了血清白蛋白和血浆纤连蛋白水平。此外，计算了乳糜泻患者的体重/身高比，并在此基础上将他们分为三组，如下：体重/身高比≤第3百分位数的乳糜泻患者；体重/身高比在第4至第10百分位数之间的患者；体重/身高比＞第10百分位数的患者。这些组之间胰凝乳蛋白酶、磷脂酶和脂肪酶的十二指肠分泌量没有显著差异。当将整个乳糜泻组与对照者进行比较时，仅脂肪酶水平显著降低（P ＜ 0.009）。然而，在5 / 52例乳糜泻患者（29%）中观察到一种或多种胰腺酶值低于正常。在4 / 52例患者中还发现残余酶活性＜正常分泌能力的10%。患者中各种胰腺酶的分泌量与白蛋白、纤连蛋白水平及体重/身高比之间没有相关性。此外，胰腺功能不全的乳糜泻患者与胰腺功能正常的患者在体重/身高比以及白蛋白和纤连蛋白水平方面没有差异。我们得出结论，轻度/中度胰腺功能不全在乳糜泻患者中相当常见，但它可能与营养状况完全无关；因此需要进一步研究以阐明其发病机制。
