DEFICIENCY IN ANTIOXIDANT FACTORS IN PATIENTS WITH ALCOHOL-RELATED CHRONIC-PANCREATITIS

Free radicals have been suspected to play a role in the pathogenicity of alcohol-related chronic pancreatitis. The aim of this study was to determine the status of several antioxidant parameters in these patien ts and examine the factors that are likely to influence them. Thirty-f ive subjects (23 males and 12 females, mean age 48 +/- 8 years) with d isease proven by endoscopic pancreatography and 14 healthy controls (6 males and 8 females, mean age 44 +/- 7 years) were included in the st udy. Biochemical antioxidant parameters included: selenium, zinc, and copper levels in plasma; glutathione peroxidase in plasma and erythroc ytes; plasma malondialdehyde concentrations assessed by thiobarbituric acid reactants; and serum vitamin E and A levels. Selenium and vitami n E oral intake was assessed by a five-day diet analysis. Hemoglobin ( 130 +/- 16 vs 143 +/- 15 g/liter), vitamin E (8 +/- 5 vs 16 +/- 9 mg/l iter), vitamin A (30 +/- 11 vs 49 +/- 12 mu g/dl), selenium (54 +/- 20 vs 87 +/- 11 mu g/liter), and plasma glutathione peroxidase (903 +/- 313 vs 1326 +/- 168 units/liter) were significantly lower in patients than in controls (P < 0.05). In contrast, white blood cell count, C-re active protein, and plasma copper levels were significantly higher in patients than in controls. Cholesterol, triglycerides, iron, ferritin, total proteins, zinc, and malondialdehyde were not different. Vitamin E was lower in patients with steatorrhea, while vitamin A was lower i n patients with concomitant diabetes mellitus. Dietary intakes were no t different between patients and controls. In conclusion, patients wit h alcohol-related chronic pancreatitis have low blood levels in many a ntioxidant factors. Dietary intakes of some of them (selenium and vita min E) are adequate, however. Such deficiencies are secondary to pancr eatic insufficiency and probably to increased requirements related to enhanced oxidative stress.