Jalal M, Campbell JA, Tesfaye S, Al-Mukhtar A, Hopper AD. Yield of testing for micronutrient deficiencies associated with pancreatic exocrine insufficiency in a clinical setting: An observational study. World J Clin Cases 2021; 9(36): 11320-11329 [PMID: 35071562 DOI: 10.12998/wjcc.v9.i36.11320]
Corresponding Author of This Article
Mustafa Jalal, MBChB, MRCP, MSc, Research Fellow, Academic Department of Gastroenterology, Sheffield Teaching Hospitals, Glossop Road, Sheffield S10 2JF, United Kingdom. mustafa.jalal@nhs.net
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 26, 2021; 9(36): 11320-11329 Published online Dec 26, 2021. doi: 10.12998/wjcc.v9.i36.11320
Yield of testing for micronutrient deficiencies associated with pancreatic exocrine insufficiency in a clinical setting: An observational study
Mustafa Jalal, Jennifer Anne Campbell, Solomon Tesfaye, Ahmed Al-Mukhtar, Andrew Derek Hopper
Mustafa Jalal, Jennifer Anne Campbell, Andrew Derek Hopper, Academic Department of Gastroenterology, Sheffield Teaching Hospitals, Sheffield S10 2JF, United Kingdom
Mustafa Jalal, Department of Infection, Immunology and Cardiovascular disease, University of Sheffield, Sheffield S10 2TN, United Kingdom
Solomon Tesfaye, Academic Unit of Diabetes and Endocrinology, Sheffield Teaching Hospitals, Sheffield S10 2JF, United Kingdom
Ahmed Al-Mukhtar, Department of Surgery, Sheffield Teaching Hospitals, Sheffield S10 2JF, United Kingdom
Author contributions: Jalal M contributed to study design, data collection, analysis and drafting the manuscript; Campbell JA contributed to data collection, interpretation of data and critically revised the manuscript; Tesfaye S and Al-Mukhtar A contributed to interpretation of data and critically revised the manuscript; Hopper AD contributed to study design, analysis, interpretation of data and critically revised the manuscript; all authors approved the final version of the manuscript.
Institutional review board statement: The study was approved by local research ethics committee (IRAS 210710).
Informed consent statement: Informed consent (STH 19471) was obtained from all patients.
Conflict-of-interest statement: Authors report no conflict of interest.
Data sharing statement: Data that support the finding of this study are available from corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mustafa Jalal, MBChB, MRCP, MSc, Research Fellow, Academic Department of Gastroenterology, Sheffield Teaching Hospitals, Glossop Road, Sheffield S10 2JF, United Kingdom. mustafa.jalal@nhs.net
Received: August 19, 2021 Peer-review started: August 19, 2021 First decision: October 2, 2021 Revised: October 17, 2021 Accepted: November 14, 2021 Article in press: November 14, 2021 Published online: December 26, 2021
ARTICLE HIGHLIGHTS
Research background
Pancreatic exocrine insufficiency (PEI) can be difficult to diagnose and causes maldigestion symptoms and malabsorption.
Research motivation
There has been a number of studies that have identified PEI associated micronutrient deficiencies (PEI-MD), however there is variation in both the frequency and type of PEI-MD reported with the majority of studies including patients with PEI due to chronic pancreatitis (CP) or CP without PEI.
Research objectives
To prospectively assess the yield and type of PEI–MD in patients with and without PEI secondary to benign pancreatic diseases.
Research methods
Patients investigated for maldigestion symptoms with Faecal Elastase-1 (FEL-1) and suspected or proven benign pancreatic disease were prospectively identified. At the time of FEL-1 testing serum samples were taken for micronutrients identified by previous studies as PEI-MD.
Research results
112 patients were recruited that underwent testing for FEL-1 and PEI-MD. PEI was identified in 41 (36.6%) patients and pancreatic CT was performed in 82 patients. Overall, a PEI-MD was identified in 21/112 (18.8%) patients. The yield of PEI-MD was 17/41 (41.5%) if PEI was present which was significantly higher than those without 4/71 (5.6%) (P = 0.0001).
Research conclusions
Testing for PEI-MD in patients with suspected pancreatic disease has a high yield, specifically when PEI and CP are found together.
Research perspectives
We recommend testing for these markers in those with symptoms suspicious of PEI and pancreatic disease and consider retesting for PEI if deficiencies occur. PEI-MD testing should include selenium, magnesium and prealbumin.
