Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2006, vol. 15, nr 4, July-August, p. 631–636

Publication type: original article

Language: English

Abnormal Metabolism of Cholesterol Fractions in Chronic Pancreatitis and Results After Surgical Treatment

Zaburzenia metabolizmu frakcji cholesterolowych obserwowane w przewlekłym zapaleniu trzustki i wyniki po operacyjnym leczeniu

Dorota Diakowska1,, Witold Diakowski2,, Witold Knast1,, Krzysztof Grabowski1,, Marta Strutyńska−Karpińska1,, Krystyna Markocka−Mączka1,

1 Department of Gastrointestinal and General Surgery, Silesian Piasts University of Medicine in Wrocław, Poland

2 Department of Cytobiochemistry, Institute of Biochemistry and Molecular Biology, Wrocław University, Wrocław, Poland

Abstract

Background. The consequence of the progressive inflammatory processes in chronic pancreatitis (CP) is exocrine pancreatic insufficiency. Patients have increased fat excretion in stool and changes in lipid fraction levels in serum.
Objectives. Measuring and evaluating the results of stool and serum fat concentrations, especially the cholesterol fraction, in patients with CP before and after surgical treatment and substitution therapy.
Material and Methods. Thirty−eight patients with CP and 15 healthy subjects were studied. The concentrations of the lipid fractions in stool and serum were determined using thin−layer chromatography (TLC), chemical tests, and electrophoresis of serum lipoproteins. The data were statistically analyzed using the Kruskal−Wallis and Spearman tests.
Results. The CP patients showed statistically significantly higher lipid concentrations in serum and stool than the control group (p < 0.001). After surgery and substitution therapy, normalization of the lipid fractions levels was observed, but the concentrations of LDL−CH and HDL−CH were irregular.
Conclusion. In CP patients, improvement of digestion and absorption function after surgery and substitution therapy is visible earlier in the normalization of lipid classes in feces than in serum. It is hoped that TLC and lipoprotein electrophoresis may be useful methods in recognizing CP and monitoring the results of its surgical treatment.

Streszczenie

Wprowadzenie. Konsekwencją procesu zapalnego w przewlekłym zapaleniu trzustki (p.z.t.) jest zaburzenie funkcji wydzielniczej tego narządu. U chorych obserwuje się zakłócenia trawienia i wchłaniania pokarmów, co w pierwszej kolejności ujawnia się uszkodzeniem metabolizmu lipidów.
Cel pracy. Ocena wyników stężenia lipidów całkowitych i frakcji cholesterolowych w kale i surowicy pacjentów z p.z.t. przed i po leczeniu operacyjnym i substytucyjnym.
Materiał i metody. Badaniami objęto grupę 38 pacjentów z p.z.t. i 15 osób zdrowych. Stężenia frakcji lipidowych kału i surowicy oznaczono za pomocą chromatografii cienkowarstwowej (TLC), testów chemicznych i elektroforezy lipoprotein surowicy. Dane analizowano statystycznie z użyciem testu Kruskala−Wallisa i testu Spearmana.
Wyniki. U pacjentów z p.z.t. stwierdzono statystycznie istotne duże stężenia frakcji lipidów złożonych w kale i surowicy w porównaniu z grupą kontrolną (p < 0,001). Po leczeniu operacyjnym i substytucyjnym stężenia frakcji lipidowych uległy normalizacji, ale stężenia frakcji HDL−CH i LDL−CH były nieprawidłowe przez cały cykl leczenia.
Wnioski. W analizach frakcji lipidowych kału, a szczególnie frakcji cholesterolowych szybciej uwidaczniają się zmiany zachodzące po zastosowaniu leczenia operacyjnego i substytucyjnego p.z.t. w porównaniu z badaniami frakcji lipidów surowicy. Uzyskane wyniki mogą sugerować wykorzystanie technik chromatografii cienkowarstwowej i elektroforezy lipoprotein surowicy w diagnostyce i naukowych analizach etiologii zapalenia trzustki.

Key words

chronic pancreatitis, serum and stool lipids, thin−layer chromatography, electrophoresis of serum lipoproteins

Słowa kluczowe

przewlekłe zapalenie trzustki, lipidy kału i surowicy, chromatografia cienkowarstwowa, elektroforeza lipoprotein surowicy

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