Prevalence of malnutrition and morphofunctional alterations of the pancreas in asymptomatic chronic alcoholic patients

BACKGROUND: The aim of this study was to assess the prevalence of morphofun ctional alterations of the pancreas and the possible association with the n utritional status of chronic alcoholic subjects in the initial phase of det oxification and without symptoms of pancreopathy. PATIENTS AND METHODS: 105 alcoholic patients with neither diagnosis nor cli nical symptoms of pancreopathy were studied, from detoxification units for alcoholics with over 30 days abstinence. The nutritional status was evaluat ed by means of clinicoanthropometric parameters (body mass index, nutrition al risk index, degree and type of malnutrition) and biological parameters ( albumin, transferrin, and total lymphocyte count). The pancreas was morphol ogically examined by means of plain X-rays, ultrasonography and/or computer tomography, applying the Cambridge criteria; also functionally (Pancreolau ryl test and fats in stools). RESULTS: The average (SD) consumption of alcohol was 195 (76) g/day (range 60-450), for 16 (8) years (3-40). Nutritional abnormalities were observed b etween 12.3% and 28% in the clinicoanthropometric parameters, and between 2 % and 32% according to the biological parameters. These abnormalities were only light or moderate. The morphologic study showed abnormalities in 3.5% of the cases. Abnormalities in the exocrine function were observed in 26% o f the cases, of which one third showed steathorrhea. A significant associat ion between the nutritional condition and the scares of the tests of exocri ne function was observed, especially in those cases with steathorrea. CONCLUSION: A large number of asymptomatic alcoholic subjects present a sub clinical pancreopathy and signs of malnutrition. Both facts may he related and justify a pancreatic examination with more sensitive techniques in alco holic individuals with malnutrition.