Relationship Between the Severity of Acute Pancreatitis and Vitamin D Level in Geriatric Patient Population

Yıl 2023, , 519 - 526, 30.09.2023

Mercan Taştemur , Çağla Özdemir , İbrahim Akdağ

https://doi.org/10.18663/tjcl.1342760

Öz

Background: It is important to determine the severity of acute pancreatitis (AP) and its prognosis.The aim of this study is to research the efficiency of vitamin D level on the severity of acute pancreatitis in geriatric population.
Methods: Files of 4108 patients were analyzed retrospectively. Serum vitamin D levels of total 404 patients (geriatric 160 (n:160); non-geriatric 244 (n:244)) were compared between mild, moderate and severe groups according to revised Atlanta classification for acute pancreatitis. Relationship between the severity of acute pancreatitis and vitamin D levels were analyzed.
Results: No significant difference was observed in non-geriatric patients in terms of vitamin D levels according to the Atlanta classification for acute pancreatitis. However, there were significant differences both between mild and moderate groups and between moderate and severe groups in geriatric patients (p<0.005). AP was more severe in patients with a low vitamin D level (p<0.005).
Conclusion:We have concluded that vitamin D levels may be insufficient to predict the severity of acute pancreatitis considering age factor, which is a substantial indicator of its prognosis. Vitamin D levels have been found out to be efficient in the severity of disease in geriatric acute pancreatitis patients compared to non-geriatric ones.

Anahtar Kelimeler

Acute pancreatitis, vitamin d, prognosis, geriatric patients.

Geriatrik Hasta Popülasyonunda Akut Pankreatit Şiddeti ile D Vitamini Düzeyi Arasındaki İlişki

Öz

Giriş: Akut pankreatitin (AP) şiddetini ve prognozunu belirlemek önemlidir. Bu çalışmanın amacı geriatrik popülasyonda D vitamini düzeyinin akut pankreatitin şiddeti üzerindeki etkinliğini araştırmaktır.
Gereç ve Yöntemler: 4108 hastanın dosyaları retrospektif olarak analiz edildi. Toplam 404 hastanın (geriatrik 160 (n:160); geriatrik olmayan 244 (n:244)) serum D vitamini düzeyleri akut pankreatit için revize Atlanta sınıflamasına göre hafif, orta ve şiddetli gruplar arasında karşılaştırıldı. Akut pankreatitin şiddeti ile D vitamini düzeyleri arasındaki ilişki analiz edildi.
Sonuçlar: Akut pankreatit için Atlanta sınıflamasına göre D vitamini düzeyleri açısından yaşlı olmayan hastalarda anlamlı bir fark gözlenmedi. Ancak, geriatrik hastalarda hem hafif ve orta gruplar arasında hem de orta ve şiddetli gruplar arasında anlamlı farklılıklar vardı (p<0,005). D vitamini düzeyi düşük olan hastalarda AP daha şiddetli idi (p<0,005).
Sonuç: Prognozun önemli bir göstergesi olan yaş faktörü göz önüne alındığında, D vitamini düzeylerinin akut pankreatitin şiddetini öngörmede yetersiz olabileceği sonucuna vardık. D vitamini düzeylerinin geriatrik akut pankreatit hastalarında geriatrik olmayanlara kıyasla hastalığın ciddiyetinde etkili olduğu bulunmuştur.

Anahtar Kelimeler

Akut Pankreatit, d vitamini, prognoz, geriatrik hastalar.

Kaynakça

• Sendler M, van den Brandt C, Glaubitz J, et. al. NLRP3 Inflammasome Regulates Development of Systemic Inflammatory Response and Compensatory Anti-Inflammatory Response Syndromes in Mice With Acute Pancreatitis. Gastroenterology. 2020;158(1):253-269.e14.
• Conwell DL, Lee LS, Yadav D, et al.American Pancreatic Association Practise Guidelines in Chronic Pancreatitis:evidence-based report on diagnostic guidelines. Pancreas. 2014;43(8):1143-62.
• Toouli J, Brooke-Smith M, Bassi C, Carr-Locke D, Telford J, Freeny P, Imrie C, Tandon R; Working Party of the Program Commitee of the Bangkok World Congress of Gastroenterology 2002. Guidelines for the management of acute pancreatitis. J Gastroenterol Hepatol. 2002 Feb;17 Suppl:S15-39.
• Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Disease and Injury Incidence and Prevalence Collaborators.Lancet. 2017;16;390(10100):1211-1259.
• El-Mahdy RI, Ramadan HK, Mohammed HSED, Ahmed EH, Mokhtar AA, Hosni A. Impact of the etiology and Vitamin D receptor TaqI rs731236 gene polymorphism on the severity of acute pancreatitis. J Hepatobiliary Pancreat Sci. 2020;27(11):896-906.
• Robin-Lersundi A, Abella Alvarez A, San Miguel Mendez C, et al. Multidisciplinary Approach to Treating Severe Acute Pancreatitis in a Low-Volume Hospital. World J Surg. 2019;43(12):2994-3002.
• Otsuki M, Takeda K, Matsuno S, et al. Criteria for the diagnosis and severity stratification of acute pancreatitis. World J Gastroenterol. 2013;21;19(35):5798-805.
• Düzenci D, Yalnız M, İspiroğlu M. Comparison between prognostic indicators in organ insufficiency with acute pancreatitis. Ulus Travma Acil Cerrahi Derg. 2021;27(4):410-420.
• Bang UC, Novovic S, Andersen AM,et al. Variations in serum 25-hydroxyvitamin D during acute pancreatitis: an exploratory longitudinal study. Endocr Res. 2011;36(4):135-41.
• Setiawan VW, Pandol SJ, Wei PC, et al. Dietary Factors Reduce Risk of Acute Pancreatitis in a Large Multiethnic Cohort. Clin Gastroenterol Hepatol. 2017;15(2):257-265.e3.
• Huh JH, Kim JW, Lee KJ. Vitamin D deficiency predicts severe acute pancreatitis. United Europan Gastroenterol J. 2019;7(1):90-95.
• Spiro A, Buttriss JL. Vitamin D: An overview of vitamin D status and intake in Europe. Nutr Bull. 2014;39(4):322-350.
• Guideline for diagnosis and treatment of osteoporosis and metabolic bone diseases © Turkish Society of Endocrinology and Metabolism. Press: November 2020 Publication date: September 8, 2020. ISBN: 978-605-4011-41-4 15
• Banks PA, Bollen TL, Dervenis C,et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Acute Pancreatitis Classification Working Group.Gut. 2013; 62(1):102-11.
• Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. Endocrine Society.J Clin Endocrinol Metab. 2011; 96(7):1911-30.
• Pokharel A, Sigdel PR, Pyal S, et al. Prediction of Severity of Acute Pancreatitis Using Total Serum Calcium and Albumin-Corrected Calcium: A Prospective Study in Tertiary Center Hospital in Nepal. Surg Res Pract. 2017;2017:1869091.
• Hummel D, Aggorwal A, Borka K,et al. The vitamin D system is deregulated in pancreatic diseases. J Steroid Biochem Mol Biol. 2014 Oct;144 Pt B:402-9.
• Kara B, Olmez S, Yalcın MS, et al. Update on the effect of age on acute pancreatitis morbidity: a retrospective, single-center study. Prz Gastroenterol. 2018;13(3):223-227.
• Losurdo G, Iannone A, Principi M, et al. Acute pancreatitis in elderly patients: a retrospective evaluation at hospital admission. Eur J Intern Med. 2016;30:88–93.
• Kim JE, Hwang JH, Lee SH, et al. The clinical outcome of elderly patients with acute pancreatitis is not different in spite of the different etiologies and severity.Arch Gerontol Geriatr . Jan-Feb 2012;54(1):256-60.
• Gardner TB, Vege SS, Chari ST, et al.The effect of age on hospital outcomes in severe acute pancreatitis. Pancreatology . 2008;8(3):265-70.
• Li Y, Zhao Y, Feng L, et al. Comparison of the prognostic values of inflammation markers in patients with acute pancreatitis: a retrospective cohort study. BMJ Open. 2017 Mar 27;7(3):e013206.
• Komolafe O, Pereira SP, Davidson BR, et al. Serum C-reactive protein, procalcitonin, and lactate dehydrogenase for the diagnosis of pancreatic necrosis. Cochrane Database Syst Rev. 2017;21;4(4):CD012645.
• Leppäniemi A, Tolonen M, Tarasconi A, et al .2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg. 2019; 14():27
• Chei CL, Roman P, Yin ZX,et al. Vitamin D levels and cognition in elderly adults in China. J.Am Geriatr Soc. 2014;62(11):2125-9.
• Brouwe Brolsma EM, Vaes AMM, L Van der Zwaluw N, et al. Relative importance of summer sun exposure, vitamin D intake, and genes to vitamin D status in Dutch older adults: The B-PROOF study. J Steroid Biochem Mol Biol. 2016;164:168-176. Epub 2015 Aug 11.