A Lind1, B Wängberg2, L Ellegård1. 1. Clinical Nutrition Unit, Department of Gastroenterology and Hepatology, Sahlgrenska University Hospital, Gothenburg, Sweden. 2. Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Abstract
BACKGROUND/ OBJECTIVES: Patients with small intestinal neuroendocrine tumours (SI-NET) often have diarrhoea from hormonal overproduction, surgery and medical treatment, leading to malabsorption of bile salts, fats, vitamin B12 and fat-souble vitamins. This could lead to malnutrition. SUBJECTS/ METHODS: We assessed nutritional status in 50 consecutive out patients with disseminated SI-NET, 25 patients in each cohort. The first cohort was descriptive and the second cohort supplemented with vitamin D, B12 and calcium. Vitamin D deficiency was defined as <50 nmol/l. All patients were assessed by clinical chemistry and dual-energy X-ray absorptiometry (DXA) and interviewed about weight changes, appetite, gastrointestinal disorders, sunhabits and the use of supplements. RESULTS: In the first cohort, 29% of the patients were severely and 17% moderately vitamin D deficient. In patients without prior substitution, 32% had subnormal vitamin B12 levels. Seventy-six percent had low bone density. In the second cohort with vitamin and mineral supplementation, none had severe vitamin D deficiency, but 28% had moderate deficiency. No patient had subnormal vitamin B12 levels. Sixty percent had low bone density. The serum levels of vitamin D and B12 were higher and parathyroid hormone (PTH) lower in the second cohort compared with the first cohort (P⩽0,022). Vitamin D and PTH were negatively correlated, r=-30, P=⩽0.036. CONCLUSIONS: Low serum levels of vitamin D and vitamin B12, and low bone density are common in patients with disseminated SI-NET. Supplementation of vitamin D, B12 and calcium resulted in higher serum levels of vitamins, lower PTH levels and diminished severe vitamin D deficiency and is thus recommended as standard care.
BACKGROUND/ OBJECTIVES:Patients with small intestinal neuroendocrine tumours (SI-NET) often have diarrhoea from hormonal overproduction, surgery and medical treatment, leading to malabsorption of bile salts, fats, vitamin B12 and fat-souble vitamins. This could lead to malnutrition. SUBJECTS/ METHODS: We assessed nutritional status in 50 consecutive out patients with disseminated SI-NET, 25 patients in each cohort. The first cohort was descriptive and the second cohort supplemented with vitamin D, B12 and calcium. Vitamin D deficiency was defined as <50 nmol/l. All patients were assessed by clinical chemistry and dual-energy X-ray absorptiometry (DXA) and interviewed about weight changes, appetite, gastrointestinal disorders, sunhabits and the use of supplements. RESULTS: In the first cohort, 29% of the patients were severely and 17% moderately vitamin D deficient. In patients without prior substitution, 32% had subnormal vitamin B12 levels. Seventy-six percent had low bone density. In the second cohort with vitamin and mineral supplementation, none had severe vitamin D deficiency, but 28% had moderate deficiency. No patient had subnormal vitamin B12 levels. Sixty percent had low bone density. The serum levels of vitamin D and B12 were higher and parathyroid hormone (PTH) lower in the second cohort compared with the first cohort (P⩽0,022). Vitamin D and PTH were negatively correlated, r=-30, P=⩽0.036. CONCLUSIONS: Low serum levels of vitamin D and vitamin B12, and low bone density are common in patients with disseminated SI-NET. Supplementation of vitamin D, B12 and calcium resulted in higher serum levels of vitamins, lower PTH levels and diminished severe vitamin D deficiency and is thus recommended as standard care.
Authors: Jaehee Kim; Stanley Heshka; Dympna Gallagher; Donald P Kotler; Laurel Mayer; Jeanine Albu; Wei Shen; Pamela U Freda; Steven B Heymsfield Journal: J Appl Physiol (1985) Date: 2004-04-16
Authors: Marianne Pavel; Eric Baudin; Anne Couvelard; Eric Krenning; Kjell Öberg; Thomas Steinmüller; Martin Anlauf; Bertram Wiedenmann; Ramon Salazar Journal: Neuroendocrinology Date: 2012-02-15 Impact factor: 4.914
Authors: Paweł Płudowski; Elżbieta Karczmarewicz; Milan Bayer; Graham Carter; Danuta Chlebna-Sokół; Justyna Czech-Kowalska; Romuald Dębski; Tamas Decsi; Anna Dobrzańska; Edward Franek; Piotr Głuszko; William B Grant; Michael F Holick; Liudmila Yankovskaya; Jerzy Konstantynowicz; Janusz B Książyk; Krystyna Księżopolska-Orłowska; Andrzej Lewiński; Mieczysław Litwin; Szimonetta Lohner; Roman S Lorenc; Jacek Lukaszkiewicz; Ewa Marcinowska-Suchowierska; Andrzej Milewicz; Waldemar Misiorowski; Michał Nowicki; Vladyslav Povoroznyuk; Piotr Rozentryt; Ema Rudenka; Yehuda Shoenfeld; Piotr Socha; Bogdan Solnica; Mieczysław Szalecki; Marek Tałałaj; Szabolcs Varbiro; Michał A Żmijewski Journal: Endokrynol Pol Date: 2013 Impact factor: 1.582
Authors: Anouk N A van der Horst-Schrivers; A N Machteld Wymenga; Thera P Links; Pax H B Willemse; Ido P Kema; Elisabeth G E de Vries Journal: Neuroendocrinology Date: 2004 Impact factor: 4.914
Authors: Barbara Altieri; Carla Di Dato; Roberta Modica; Filomena Bottiglieri; Antonella Di Sarno; James F H Pittaway; Chiara Martini; Antongiulio Faggiano; Annamaria Colao Journal: Nutrients Date: 2020-04-08 Impact factor: 5.717
Authors: Halfdan Sorbye; Liv Sylvi Meyer; Kjersti Elisabeth Mordal; Simen Myhre; Espen Thiis-Evensen Journal: Health Qual Life Outcomes Date: 2020-06-16 Impact factor: 3.186