Journal article

Publication year: 2008

Pages: 68-72

Journal: European Journal of Medical Research

Volume number: 13

Issue number: 2

ISSN: 0949-2321

Publisher: BioMed Central

Abstract: 

Background and Aims: The aim of the present study was to clarify if patients with osteoporotic bone fractures have exocrine pancreatic insufficiency especially reduced fecal elastase 1, connected with lowered serum levels of vitamin D-3 that could be relevant for predominant osteoporosis.

Methods: Between October 1999 and September 2001, we investigated on 167 patients with an average age of approx. 69 years suffering from typical osteoporotic bone fractures, as well as 20 healthy controls with an average age of 53 years. A standardized osteodensitometry via dual energy X-ray absorptiometry (DEXA) was performed in all participants. Levels of PTH, 1,25(OH)(2) Vitamin D-3, 25(OH)Vitamin D-3, calcium and phosphate in serum, elastase 1 in feces as well as the body mass index were determined in all patients and controls.

Results: In patients 25(OH)D-3 was more than 60% and 1,25(OH)(2)D-3 was more than 53% decreased compared to controls. Fecal elastase 1 was lower than the lowest reference of 200 mu g/g feces in more than 34% of the patients and it was more than 65% reduced in comparison to healthy controls (fecal elastase 1 patients: 240.7 +/- 96.3 mu g/g; controls 694.9 +/- 138.6 mu g/g). Separation of the patients in accordance with the elastase 1 contend in feces into four groups (below 100 mu g/g, between 100 and 200 mu g/g, between 201 and 300 mu g/g and above 300 mu g/g) resulted in significant variations for 25(OH)D-3, 1,25(OH)(2)D-3, calcium and PTH between these groups (p < 0.01). Furthermore 25(OH)D-3, 1,25(OH)(2)D-3, calcium and PTH correlated significantly with elastase 1 in feces (p < 0.01) the way, that lower fecal elastase 1 was connected with lower levels of the other parameters. BMI shows no relevant differences within the patients or between patients and controls.

Conclusion: Exocrine pancreatic insufficiency, especially lowered fecal elastase 1, may be much more frequent in patients with osteoporotic bone fractures than suggested so far. Lowered exocrine pancreatic function with lowered fecal elastase 1 seems to be relevant as a reason for reduced levels of circulating vitamin D-3 metabolites being an appropriate additional cause for predominant osteoporosis.

Harvard Citation style: Mann, S., Mann, V., Stracke, H., Lange, U., Kloer, H., Hardt, P., et al. (2008) Fecal elastase 1 and vitamin D3 in patients with osteoporotic bone fractures, European Journal of Medical Research, 13(2), pp. 68-72

APA Citation style: Mann, S., Mann, V., Stracke, H., Lange, U., Kloer, H., Hardt, P., & Teichmann, J. (2008). Fecal elastase 1 and vitamin D3 in patients with osteoporotic bone fractures. European Journal of Medical Research. 13(2), 68-72.