Vitamin D in patients with pancreatic diseases

Gianvico Melzi D'eril1,*, Alessandra Barassi1, Raffaele Pezzilli2

1Laboratorio di Analisi, Ospedale San Paolo, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, 2Dipartimento di Malattie dell’Apparato Digerente e Medicina Interna, Ospedale Sant'Orsola-Malpighi, Alma Mater Studiorum, Università degli Studi di Bologna, Bologna, Italy

Introduction: There are no extensive data on the comparative evaluation of 25-hydroxyvitamin D (VIT D) serum levels in patients with chronic benign and malignant pancreatic diseases.

Objectives: We evaluated serum VIT D levels in patients with chronic pancreatitis (CP), pancreatic adenocarcinoma (PA) and in healthy subjects (HS).

Methods: Sixty-nine consecutive subjects were studied: 20 patients with a firm diagnosis of CP (12M, 8F; mean age 56.0 y), 20 histologically confirmed PA (11M, 9F; mean age 63.5 y); 29 HS (13M, 16F; mean age 59.5 y). Serum VIT D levels were measured using chemiluminescence assay (CLIA) (DiaSorin, Italy). VIT D levels were normally distributed and ANOVA test was applied to analyse the data. In addition, fecal pancreatic elastase-1 (FE), as marker of exocrine pancreatic insufficiency (ScheBo Biotech AG, Germany), was also measured in patients with pancreatic diseases.

Results: The 3 groups of subjects were comparable for sex (P=0.554) and age (P=0.107); exocrine pancreatic insufficiency (FE <200 µg/g) was present in 14 patients with CP and in 1 patient with PA (P<0.001). Serum VIT D was significantly different among the 3 groups of patients studied (mean±SD; 10.9±8.1 ng/mL in CP patients, 12.5±5.6 ng/mL in PA patients and 23.6±8.3 ng/mL in HS; P<0.001). CP and PA patients had similar VIT D serum levels (P=0.258) and these levels were significantly lower than those of HS (P<0.001). Taking into consideration clinical parameters such as the disease (CP, PA, HS), sex, exocrine pancreatic insufficiency, alcohol, smoking habit, pancreatic calcifications, pain and diabetes mellitus, only the type of the disease (i.e. CP or PA) at univariate analysis was significantly associated with low VIT D levels (P=0.036).

Conclusion: Low VIT D levels are associated with chronic diseases of the pancreas, but the mechanism should be elucidated because these low levels are not associated with sex, exocrine pancreatic insufficiency, alcohol and smoking habit, pancreatic calcifications, pain and diabetes mellitus.

Keywords: Biomarker, Cancer, Inflammation