The role of phosphorus-calcium homeostasis and vitamin D in the pathogenesis of acute pancreatitis and assessment of its severity
I.V. Kolosovych, I.V. Hanol
Bogomolets National Medical University, Department of Surgery No.2, Kyiv, Ukrainе
DOI: https://doi.org/10.15407/fz68.03.061
Abstract
The aim of the study was to determine the role of phosphorus-calcium homeostasis and vitamin D 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 group (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), and 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). 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). 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).
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. Thus, the content of vitamin D levels ≤13.28 ng/ml
for patients with acute pancreatitis can be considered as a threshold at which severe disease is predicted
is predicted, at the same time the level of calcium decrease correlates with an increase in the severity of
acute pancreatitis, which can be considered a reliable criterion for the severity of the disease, however,
significant changes in phosphorus metabolism are not identified.
Keywords:
acute pancreatitis; vitamin D; calcium; the severity of the disease
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