Table of Contents
ISRN Gastroenterology
Volume 2011 (2011), Article ID 951686, 5 pages
http://dx.doi.org/10.5402/2011/951686
Research Article

Prevalence of Exocrine Pancreatic Insufficiency in Women with Obesity Syndrome: Assessment by Pancreatic Fecal Elastase 1

1Department of Gastroenterology, Endocrinology, and Diabetology, Klinikum Lüdenscheid, 58515 Lüdenscheid, Germany
2Department of Internal Medicine, Medical Clinic C, 67063 Ludwigshafen, Germany
3Department of Rheumatology, Osteology and Physical Therapy, William G. Kerckhoff Foundation, Justus Liebig University Giessen, 35385 Giessen, Germany

Received 4 August 2011; Accepted 13 September 2011

Academic Editor: C. Sperti

Copyright © 2011 J. Teichmann et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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 D3 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 3 5 ≀ 4 0  kg/m2), calcifediol was markedly decreased ( 2 5 . 0 Β± 4 . 9  ng/mL) compared to controls ( 5 0 . 2 Β± 1 4 . 7  nmol/L; 𝑃 < 0 . 0 1 ). FE1 level was significantly decreased in obese subjects compared to controls ( 𝑃 < 0 . 0 1 ). Calcifediol was significantly lower in patients with morbid obesity (for calcifediol, 𝑃 < 0 . 0 5 ). Conclusion. In obese females, pancreatic FE1 in feces confirms the extent of vitamin D supply, and thus shows a vitamin D3 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.