Anthropometric measurements of nutritional status in chronic pancreatitis in India: comparison of tropical and alcoholic pancreatitis
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Undernutrition is considered to be a cause of tropical pancreatitis (TP) since this disease is commonly seen in the underprivileged populations of the world. This study was done to compare the nutritional status in patients with TP and alcoholic chronic pancreatitis (ACP) using anthropometric measurements.
Anthropometric measurements were done in patients with TP and ACP aged >18 years and matched healthy controls. Presence of pain, recent dietary restriction, diabetes mellitus (DM), calcification, serum prealbumin (PAB), and quantitative fecal elastase (FE) was assessed. Premorbid body mass index (BMI) was determined from weight before the onset of illness as reported by the patients.
Of 54 patients (47 male), 39 (72.2%) had TP and the rest had ACP. Patients with TP were younger than those with ACP; the frequency of pain, DM, calcification, and exocrine insufficiency was similar in the two groups. Compared to control subjects, patients had lower BMI, triceps skin fold thickness (TSFT) and mid-arm circumference (MAC) (p < 0.01), but waist-to-hip ratio (W/H) was similar. Undernutrition was equally common in TP and ACP (15 [38.5%] vs. 6 [40%]). The BMI, TSFT, MAC, and W/H were similar in TP and ACP. The premorbid BMI was higher than that at presentation (20.2 [3.8] kg/m² vs. 19.1 [3.3] kg/m², p < 0.01). There was no association between BMI and features contributing to undernutrition (DM, pain, recent dietary restriction, FE level, and calcification) on univariate analysis.
Energy undernutrition occurs equally commonly in TP and ACP and this appears to develop after the onset of illness.
KeywordsAnthropometry Fecal elastase Prealbumin Tropical calcific pancreatitis Undernutrition
The authors gratefully acknowledge the assistance provided by Mr. Sivaramakrishnan, retired statistician (Occupational Health, BHEL) Trichy, India and Ms. Asha Kamath, Department of Community Medicine, Kasturba Medical College, Manipal for their help with statistical analysis. This study was supported by an ad-hoc grant from the Indian Council of Medical Research (ICMR, IRIS ID: 2007–04900).
These data were presented in part at the Digestive Disease Week 2009, Chicago, IL (May 30–June 4, 2009).
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