The role of phosphorus-calcium homeostasis and vitamin d in the pathogenesis of acute pancreatitis and assessment of its severity

Abstract

The aim of the study was to determine the role of phosphorus-calcium and vitamin D homeostasis in the pathogenesis of acute pancreatitis and assess the severity of its course. We examined 72 people, who were divided into two groups: the first group (comparison group) - men and women without pathology of the gastrointestinal tract and any other conditions or diseases that could affect the state of calcium-phosphorus metabolism (n=36) and the second (main) group - patients with acute pancreatitis (n=36). Additionally patients in the main group were divided into two subgroups. The first subgroup included patients with severe disease (n=18), the second (n=18) - with mild and moderate disease. In patients with acute pancreatitis, the incidence of vitamin D deficiency (<20 ng/ml) was significantly higher than in the comparison group, and was 72.2% and 5.6%, respectively (χ2=33.1, 95% CI 46.1-79.2, p<0.0001). The incidence of severe vitamin D deficiency (<10 ng /ml) in patients with severe acute pancreatitis was significantly higher than in patients with mild to moderate disease, and was 55.6% and 5.6% respectively (χ2=10.3, 95% CI 20.2-70.4, p=0.001). Hypocalcemia in terms of total calcium was registered probably more often in patients with severe acute pancreatitis - 61.1% than in patients with mild and moderate - 16.7% (χ2=7.3, 95% CI 12.5-65.9, p<0.05). Patients with the lowest quartile of vitamin D and total calcium had a significantly more severe course of acute pancreatitis than those with the highest quartile. Serum vitamin D levels ≤13.28 ng/ml for patients with acute pancreatitis can be considered as a threshold at which severe disease is predicted.