Variations in the levels of oxidative stress and antioxidants during early acute pancreatitis.

Aim: Acute pancreatitis (AP) is fatal when severe and oxidative stress (OS) is postulated to play an important role in its pathophysiology and the development of complications. OS and antioxidant status therefore need to be profiled during early AP. Methods: Patients presenting to the Gastroenterology wards with early AP i.e. within 72 hours of onset of pain were included in the study. Also samples from 50 healthy controls were obtained for comparison. OS was estimated by levels of blood superoxide dismutase (SOD) and lipid peroxidation (thiobarbituric acid reactive substances; TBARS) and antioxidant status (AOS) by the ferric reducing ability of plasma (FRAP) and vitamin C at days 1, 3, and 7 of admission. Results: OS was significantly higher in cases as compared with controls (p<0.001) on all days and showed a gradual decrease from day 1 to 7 (p<0.05). TBARS showed a higher fall in mild AP and better clinical outcome (p<0.003). Regarding the AOS, FRAP was significantly lower in cases (p<0.001) and decreased significantly from day 1 to 3 (p=0.017). Conclusions: High OS was observed during early phase of AP and a gradually improving AOS was associated with a better clinical outcome in patients with AP.

Micronutrient antioxidant intake in patients with chronic pancreatitis.

Increased oxidative stress has been postulated to be an important mechanism in the pathophysiology of chronic pancreatitis (CP). Micronutrient deficiency may increase the oxidative stress as they assist in free radical clearance. The present study was undertaken to assess the intake of micronutrients, i.e. vitamins E and C, carotene, selenium, copper, zinc, manganese, magnesium, sulphur, riboflavin, methionine and choline in patients with CP. All consecutive patients with CP attending the Pancreas Clinic at the All India Institute of Medical Sciences were enrolled in the study. The usual dietary intake was estimated by the 24-hour dietary recall method and food frequency questionnaire. Dietary restrictions, if any, were also noted. The micronutrient intake of patients not on any nutritional supplements (n=75, 65 males and 10 females, mean age 31.06 +/- 10.64 years) was compared with age- and sex- matched healthy controls (n=75). The micronutrients were calculated as per the Nutritive value of Indian Foods given by the National Institute of Nutrition, Indian Council of Medical Research, India and the US dietary intake guidelines as applicable. It was found that the Body Mass Index (BMI) of patients was significantly lower than that of healthy controls. The total intake in terms of calorie was lower in patients when compared to controls. The dietary intake of vitamin E, riboflavin, choline, magnesium, copper manganese and sulfur was significantly lower than that of controls as well as the Recommended Dietary Allowance (RDA). Dietary intake of selenium and vitamin C was within the limits of the RDA but was lower than that of controls, while the intake of carotene was similar in both the groups and met the RDA. We conclude that patients with CP had significantly decreased micronutrient intake owing to diet modification due to pain. Micronutrient deficiency might contribute to increased oxidative stress in these patients.