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Diabetes mellitus worsens antioxidant status in patients with chronic pancreatitis^1,2,3

¹ From the Service de Diabétologie, Maladies Métaboliques et Nutrition, Hôpital Jeanne d'Arc, CHU de Nancy, France (DQ and OZ); the Centre d'Investigation Clinique, CHU de Nancy, France (DQ); the Centre Universitaire de Mesure et d'Analyse, Faculté de Pharmacie, Université de Lille II, Lille, France (J-PB); and INSERM U325, Département d'Athérosclérose, Institut Pasteur de Lille et Faculté de Pharmacie, Université de Lille 2, Lille, France (EW, J-CF, and PD)

Background: Patients with chronic pancreatitis (CP) are at high risk of antioxidant deficiencies. Furthermore, this disease can lead to diabetes mellitus (DM) that could exacerbate the severity of oxidative stress. Oxidative stress and the resulting LDL oxidation are a major cause of atherosclerosis.

Objective: The objective of the study was to ascertain whether diabetes significantly modifies oxidative status in patients with CP.

Design: CP patients with or without DM were compared with type 1 DM patients and healthy control subjects.

Results: Two-way factorial analyses showed that a decrease in the plasma concentrations of vitamin A, vitamin E, and carotenoids accompanied both CP and DM, and CP was also associated with lower plasma concentrations of selenium and zinc, lower catalase activity, and higher plasma concentrations of copper. The lag phase of LDL oxidation was lower in CP patients with or without DM than in the control subjects, whereas there was no significant difference between type 1 DM patients and control subjects. Multivariate analysis showed that LDL vitamin E (R² = 0.24, P < 0.0001) and fasting plasma glucose (R² = 0.32, P < 0.0001) concentrations were the main determinants of the lag phase of LDL oxidation.

Conclusions: Antioxidant status is altered in CP patients, particularly in those who also have DM. In these patients, a vitamin E deficiency and an elevated plasma glucose concentration were associated with significantly higher LDL oxidizability.

Key Words: Chronic pancreatitis • diabetes mellitus • antioxidant • oxidized LDL • immune complexes • malondialdehyde