Related Factors And Changes Of Vitamins Metabolism In Acute Pancreatitis

Objective:To observe the related factors and changes of vitamins metabolism in acute pancreatitis(AP).Methods:A total of 111 patients diagnosed with AP and 37 healthy control subjects were enrolled in study.The 111 patients with AP were divided into three groups according to the severity of AP: mild acute pancreatitis(MAP)(n=39),mild-severe acute pancreatitis(MSAP)(n=38),and severe acute pancreatitis(SAP)(n=34).In the case of intravenous supplement to conventional recommended amounts of vitamins,plasma vitamins were measured and the score of Bedside Index for Severity in Acute Pancreatitis were determined.Differences in plasma vitamins were evaluated,and related factors of vitamins metabolism were determined.Results:(1)There were no significantly differences between acute pancreatitis patients and healthy volunteers,in plasma vitamin B1?B2?B6?B9?B12.(2)In acute pancreatitis patients,plasma vitamin A,C,D and E were significantly lower than those in healthy volunteers.Among them,the SAP group was lower than healthy control group,the difference was statistically significant(P < 0.01).There was significant reduction in the concentration of vitamin C?D?E between the MAP,SMAP group and SAP group(P < 0.01);(3)In single factor analysis,the relationship between age and vitamin C was significantly negative correlation(r = 0.294,P = 0.294).The other three vitamins were not associate with age.Blood fasting days > 7 days of vitamin C concentration in patients with acute pancreatitis group was significantly less than < 7 days.the difference was statistically significant,while the concentration of vitamin A,D,E are no difference.Serum concentration of vitamin A,C,D,E has nothing to do with the gender,BMI,the length of fasting before blood taken,in acute pancreatitis patients.(4)These variables were analyzed with multiple linear regressions and found that the plasma vitamin A,C,D and E had nothing to do with patients gender,height,body weight,body mass index,serum albumin,white blood cells,hemoglobin,CRP,PCT and hospitalization days,but those were obviously related with BISAP score.Beside,the vitamin C were also correlated with the length of fasting before blood taken and age.The multiple regression equation of concentration of vitamin A and BISAP score was y=0.589-0.04x;The multiple regression equation of concentration of vitamin D and BISAP score was was y=76.634-14.917x;The multiple regression equation of concentration of vitamin E and BISAP score was y=12.16-7.28x;The concentration of vitamin C and BISAP score(x1),the length of fasting before blood taken(x2),age(x3).The multiple regression equation was y=40.019-1.852x1-0.447x2-0.052x3.Conclusion:(1)The plasma vitamin A,C,D and E in different types of acute pancreatitis are significantly different.(2)The plasma vitamin A,C,D and E were obviously related with the severity of illness.(3)The vitamin C were also correlated with the length of fasting before blood taken and age.(4)Conventional recommended amount of vitamin A,C,D and E can't meet the body's requirement in severe acute pancreatitis.