Effects of micronutrient status on oxidative stress and exocrine pancreatic function in patients with chronic pancreatitis

Micronutrient deficiency and oxidative stress in relation to pancreatic exocrine insufficiency among chronic pancreatitis (CP) patients needs closer scrutiny. In this study, we examined the role of micronutrients (Zn and Cu) on oxidative stress related parameters and stool elastase-1 in tropical chronic pancreatitis (TCP) and alcoholic chronic pancreatitis (ACP) patients. We also compared oxidative stress parameters in CP patients with low and normal pancreatic stool elastase-1, estimation of which is the best available test for detecting pancreatic exocrine insufficiency. Ninety-one (56 male and 35 female) TCP cases, 84 ACP cases and 113 (60 male and 24 female) healthy controls were studied. Levels of reduced glutathione (GSH), ascorbic acid and zinc and activities of glutathione peroxidase (GPx), superoxide dismutase (SOD) reduced significantly, while thiobarbituric acid reactive substance (TBARS) and copper level increased significantly in erythrocytes of both ACP and TCP patients in comparison to healthy controls. However, we did not find differences in these parameters between diabetic and non-diabetic TCP patients or between diabetic and non-diabetic ACP patients. The study suggested an association between pancreatic exocrine insufficiency and oxidative parameters, while zinc deficiency was found to be correlated with SOD and pancreatic exocrine insufficiency in CP, irrespective of its etiology.