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The effect of primary hyperparathyroidism on pancreatic exocrine function

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Abstract

Background

Elastase-1 is a proteolytic enzyme secreted by pancreatic acinar cells, and measurements of the concentration this enzyme are used to evaluate pancreatic exocrine function. We aimed to determine whether pancreatic exocrine function declines due to chronic hypercalcemia by measuring fecal elastase levels.

Methods

75 patients with primary hyperparathyroidism (18 men and 47 women) and 30 healthy subjects (11 men and 19 women) participated in this study. Renal function tests, lipid parameters, bone mineral density, and serum calcium, phosphorus, vitamin D, parathormone, glucose, and thyroid stimulating hormone levels as well as fecal elastase concentrations, were determined in these patients and controls.

Results

The mean fecal elastase level was 335.3 ± 181.4 μg/g in the PHPT group and 317.4 ± 157.3 μg/g in the control group. There was no significant difference in fecal elastase levels between the two groups (p = 0.5).

Conclusions

Chronic hypercalcemia in primary hyperparathyroidism did not decrease the fecal elastase level, which is an indirect indicator of chronic pancreatitis; therefore, chronic hypercalcemia in PHPT may not cause chronic pancreatitis.

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References

  1. Naruse S, Ishiguro H, Ko SBH et al (2006) Fecal pancreatic elastase: a reproducible marker for severe exocrine pancreatic insufficiency. J Gastroenterol 41:901–908

    Article  CAS  PubMed  Google Scholar 

  2. Stevens T, Conwell DL. Pancreatic exocrine function tests. http://www.uptodate.com/contents/pancreatic-exocrine-function-testssource=search_result&search=pancreatic+exocrine+function+tests&selectedTitle=1~7. Accessed June 2017

  3. Sziegoleit A (1984) A novel proteinase from human pancreas. Biochem J 219:735–742

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Stein J, Jung M, Sziegoleit A et al (1996) Immunoreactive elastase I: clinical evaluation of a new noninvasive test of pancreatic function. Clin Chem 42(2):222–226

    CAS  PubMed  Google Scholar 

  5. Löser C, Mollgaard A, Folsch UR (1996) Faecal elastase 1: a novel, highly sensitive and specific tubeless pancreatic function test. Gut 39:580–586

    Article  PubMed  PubMed Central  Google Scholar 

  6. Dominic R, Franzini C (2002) Fecal Elastase-1 as a test for pancreatic function: a review. Clin Chem Lab Med 40(4):325–332

    Google Scholar 

  7. Shane E, Dinaz I (2006) Hypercalcemia: pathogenesis, clinical manifestations, differential diagnosis and management. In: Favus MJ (ed) Primer on the metabolic bone disease and disorders of mineral metabolism, 6th edn. Lippincott, Williams, and Wilkins, Philadelphia, p 176

    Google Scholar 

  8. Marcocci C, Brandi ML, Scillitani A et al (2015) Italian society of endocrinology consensus statement: definition, evaluation and management of patients with mild primary hyperparathyroidism. J Endocrinol Invest 38:577–593

    Article  CAS  PubMed  Google Scholar 

  9. Mithöfer K, Fernandez-del Castillo C, Frick TW et al (1995) Acute hypercalcemia causes acute pancreatitis and ectopic trypsinogen activation in the rat. Gastroenterology 109(1):239–246

    Article  PubMed  Google Scholar 

  10. Bhadada SK, Updawat HP, Bhansali A et al (2007) Chronic pancreatitis in primary hyperparathyroidism: comparison with alcoholic and idiopathic chronic pancreatitis. J Gastoenterol Hepatol 28:959–964

    Google Scholar 

  11. Jacob JJ, Chacko A, Selvan B et al (2008) Primary hyperparathyroidism and chronic pancreatitis. J Gastroenterol Hepatol 233:164

    Google Scholar 

  12. Niederle B, Roka R, Woloszczuk W (1987) Successful parathyroidectomy in primary hyperparathyroidism: a clinical follow-up study of 212 consecutive patients. Surgery 102(6):903–909

    CAS  PubMed  Google Scholar 

  13. Bess MA, Edis AJ, van Heerden JA (1980) Hyperparathyroidism and pancreatitis. Chance or a causal association? JAMA 243:246–247

    Article  CAS  PubMed  Google Scholar 

  14. Carnaille B, Oudar C, Pattou F (1998) Pancreatitis and primary hyperparathyroidism: forty cases. Aust NZ J Surg 68(2):117–119

    Article  CAS  Google Scholar 

  15. Wolkowiak J, Nousia-Arvanitakis S, Cade A et al (2002) Fecal elastase-1 cut of levels in assessment of exocrine pancreatic function in cystic fibrosis. J Cystic Fibrosis 1(4):260–264

    Article  Google Scholar 

  16. Bauer S, Amman R (1994) Chronic pancreatitis and primary hyperparathyroidism. Scweiz Med Wochenschr 124(30):1344–1348

    CAS  Google Scholar 

  17. Ward JB, Peterson OH, Jenkins SA et al (1995) Is an elevated concentration of acinar cytosolic free ionized calcium the trigger for acute pancreatitis? Lancet 346:1016–1019

    Article  CAS  PubMed  Google Scholar 

  18. Hart PA, Conwell DL (2015) Diagnosis of exocrine pancreatic insufficiency. Curr Treat Options Gastroenterol 13(3):347–353

    Article  PubMed  Google Scholar 

  19. Mann ST, Stracke H, Lange U et al (2003) Alterations of bone mineral density and bone metabolism in patients with carious grades of chronic pancreatitis. Metabolism 52(5):579–585

    Article  CAS  PubMed  Google Scholar 

  20. Moran CE, Sosa EG, Martinez SM et al (1997) Bone mineral density in patients with pancreatic insufficiency and steatorrea. Am J Gastroenterol 92:867–871

    CAS  PubMed  Google Scholar 

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Correspondence to P. Sisman.

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The authors have no conflicts of interest to disclose.

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This study was approved by the Institutional Review Board of the Uludag University of the Turkey.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Our research involved human participants who had obtained informed consent.

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Sisman, P., Avci, M., Akkurt, A. et al. The effect of primary hyperparathyroidism on pancreatic exocrine function. J Endocrinol Invest 41, 293–298 (2018). https://doi.org/10.1007/s40618-017-0727-6

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  • DOI: https://doi.org/10.1007/s40618-017-0727-6

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