Abstract

BACKGROUND & AIMS: Exocrine pancreatic function is affected in patients with locally advanced pancreatic cancer (LAPC), clinically leading to steatorrhea. It is unknown whether maldigestion and malabsorption can also be attributed to impaired intestinal enterocyte function. In this exploratory study enterocyte function was assessed in patients with locally advanced pancreatic cancer, treated with Irreversible Electroporation (IRE).

METHODS: Enterocyte function was studied by Citrulline Generation Test (CGT). Intestinal absorption capacity of energy and fat was calculated from the differences between nutritional intake (four-days diary) and quantified fecal losses energy and fat in three-days feces collection.

RESULTS: Twelve patients were included before IRE, and 5 patients had follow-up measurements. Fasted citrulline [CIT] and glutamine [GLU] levels were below reference levels of healthy subjects ([CIT] 38 ± 8 μmol/L; [GLU] 561 ± 77 μmol/L) both before ([CIT] 25 ± 9 μmol/L; [GLU] 65 ± 35 μmol/L) and after IRE ([CIT] 19 ± 9 μmol/L; [GLU] 53 ± 26 μmol/L) whereas CGT curves were normal, indicating normal enterocyte function (slope 0.21 ± 0.12 and 0.17 ± 0.07 μmol/L/min; [CIT] increment 63 ± 39 and 80 ± 44% respectively). Severe energy/fat malabsorption was present in 6 out of 12 patients with LAPC (mean loss 349 kcal/d, 13 g fat/d) before and in 4 out of 5 patients (mean loss 509 kcal/d, 32 g fat/d) after IRE respectively.

CONCLUSIONS: Enterocyte function was generally within reference limits in patients with advanced pancreatic cancer. Severe malabsorption may be explained by exocrine pancreatic insufficiency.

Original languageEnglish
Pages (from-to)2778-2782
JournalClinical Nutrition
Volume38
Issue number6
DOIs
Publication statusPublished - Dec 2019

Cite this

@article{6dbefb79b0054deeaa262b1b2006ffba,
title = "Exocrine pancreatic and enterocyte function in patients with advanced pancreatic cancer",
abstract = "BACKGROUND & AIMS: Exocrine pancreatic function is affected in patients with locally advanced pancreatic cancer (LAPC), clinically leading to steatorrhea. It is unknown whether maldigestion and malabsorption can also be attributed to impaired intestinal enterocyte function. In this exploratory study enterocyte function was assessed in patients with locally advanced pancreatic cancer, treated with Irreversible Electroporation (IRE).METHODS: Enterocyte function was studied by Citrulline Generation Test (CGT). Intestinal absorption capacity of energy and fat was calculated from the differences between nutritional intake (four-days diary) and quantified fecal losses energy and fat in three-days feces collection.RESULTS: Twelve patients were included before IRE, and 5 patients had follow-up measurements. Fasted citrulline [CIT] and glutamine [GLU] levels were below reference levels of healthy subjects ([CIT] 38 ± 8 μmol/L; [GLU] 561 ± 77 μmol/L) both before ([CIT] 25 ± 9 μmol/L; [GLU] 65 ± 35 μmol/L) and after IRE ([CIT] 19 ± 9 μmol/L; [GLU] 53 ± 26 μmol/L) whereas CGT curves were normal, indicating normal enterocyte function (slope 0.21 ± 0.12 and 0.17 ± 0.07 μmol/L/min; [CIT] increment 63 ± 39 and 80 ± 44{\%} respectively). Severe energy/fat malabsorption was present in 6 out of 12 patients with LAPC (mean loss 349 kcal/d, 13 g fat/d) before and in 4 out of 5 patients (mean loss 509 kcal/d, 32 g fat/d) after IRE respectively.CONCLUSIONS: Enterocyte function was generally within reference limits in patients with advanced pancreatic cancer. Severe malabsorption may be explained by exocrine pancreatic insufficiency.",
keywords = "Citrulline, Citrulline generation test, Glutamine, Malabsorption, Pancreatic cancer",
author = "{Witvliet-van Nierop}, {J E} and {de van der Schueren}, {M A E} and Scheffer, {H J} and Vroomen, {L G} and Meijerink, {M R} and {van Bodegraven}, {A A} and Wierdsma, {N J}",
note = "Copyright {\circledC} 2018. Published by Elsevier Ltd.",
year = "2019",
month = "12",
doi = "10.1016/j.clnu.2018.12.005",
language = "English",
volume = "38",
pages = "2778--2782",
journal = "Clinical Nutrition",
issn = "0261-5614",
publisher = "Churchill Livingstone",
number = "6",

}

Exocrine pancreatic and enterocyte function in patients with advanced pancreatic cancer. / Witvliet-van Nierop, J E; de van der Schueren, M A E; Scheffer, H J; Vroomen, L G; Meijerink, M R; van Bodegraven, A A; Wierdsma, N J.

In: Clinical Nutrition, Vol. 38, No. 6, 12.2019, p. 2778-2782.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Exocrine pancreatic and enterocyte function in patients with advanced pancreatic cancer

AU - Witvliet-van Nierop, J E

AU - de van der Schueren, M A E

AU - Scheffer, H J

AU - Vroomen, L G

AU - Meijerink, M R

AU - van Bodegraven, A A

AU - Wierdsma, N J

N1 - Copyright © 2018. Published by Elsevier Ltd.

PY - 2019/12

Y1 - 2019/12

N2 - BACKGROUND & AIMS: Exocrine pancreatic function is affected in patients with locally advanced pancreatic cancer (LAPC), clinically leading to steatorrhea. It is unknown whether maldigestion and malabsorption can also be attributed to impaired intestinal enterocyte function. In this exploratory study enterocyte function was assessed in patients with locally advanced pancreatic cancer, treated with Irreversible Electroporation (IRE).METHODS: Enterocyte function was studied by Citrulline Generation Test (CGT). Intestinal absorption capacity of energy and fat was calculated from the differences between nutritional intake (four-days diary) and quantified fecal losses energy and fat in three-days feces collection.RESULTS: Twelve patients were included before IRE, and 5 patients had follow-up measurements. Fasted citrulline [CIT] and glutamine [GLU] levels were below reference levels of healthy subjects ([CIT] 38 ± 8 μmol/L; [GLU] 561 ± 77 μmol/L) both before ([CIT] 25 ± 9 μmol/L; [GLU] 65 ± 35 μmol/L) and after IRE ([CIT] 19 ± 9 μmol/L; [GLU] 53 ± 26 μmol/L) whereas CGT curves were normal, indicating normal enterocyte function (slope 0.21 ± 0.12 and 0.17 ± 0.07 μmol/L/min; [CIT] increment 63 ± 39 and 80 ± 44% respectively). Severe energy/fat malabsorption was present in 6 out of 12 patients with LAPC (mean loss 349 kcal/d, 13 g fat/d) before and in 4 out of 5 patients (mean loss 509 kcal/d, 32 g fat/d) after IRE respectively.CONCLUSIONS: Enterocyte function was generally within reference limits in patients with advanced pancreatic cancer. Severe malabsorption may be explained by exocrine pancreatic insufficiency.

AB - BACKGROUND & AIMS: Exocrine pancreatic function is affected in patients with locally advanced pancreatic cancer (LAPC), clinically leading to steatorrhea. It is unknown whether maldigestion and malabsorption can also be attributed to impaired intestinal enterocyte function. In this exploratory study enterocyte function was assessed in patients with locally advanced pancreatic cancer, treated with Irreversible Electroporation (IRE).METHODS: Enterocyte function was studied by Citrulline Generation Test (CGT). Intestinal absorption capacity of energy and fat was calculated from the differences between nutritional intake (four-days diary) and quantified fecal losses energy and fat in three-days feces collection.RESULTS: Twelve patients were included before IRE, and 5 patients had follow-up measurements. Fasted citrulline [CIT] and glutamine [GLU] levels were below reference levels of healthy subjects ([CIT] 38 ± 8 μmol/L; [GLU] 561 ± 77 μmol/L) both before ([CIT] 25 ± 9 μmol/L; [GLU] 65 ± 35 μmol/L) and after IRE ([CIT] 19 ± 9 μmol/L; [GLU] 53 ± 26 μmol/L) whereas CGT curves were normal, indicating normal enterocyte function (slope 0.21 ± 0.12 and 0.17 ± 0.07 μmol/L/min; [CIT] increment 63 ± 39 and 80 ± 44% respectively). Severe energy/fat malabsorption was present in 6 out of 12 patients with LAPC (mean loss 349 kcal/d, 13 g fat/d) before and in 4 out of 5 patients (mean loss 509 kcal/d, 32 g fat/d) after IRE respectively.CONCLUSIONS: Enterocyte function was generally within reference limits in patients with advanced pancreatic cancer. Severe malabsorption may be explained by exocrine pancreatic insufficiency.

KW - Citrulline

KW - Citrulline generation test

KW - Glutamine

KW - Malabsorption

KW - Pancreatic cancer

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U2 - 10.1016/j.clnu.2018.12.005

DO - 10.1016/j.clnu.2018.12.005

M3 - Article

VL - 38

SP - 2778

EP - 2782

JO - Clinical Nutrition

JF - Clinical Nutrition

SN - 0261-5614

IS - 6

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