ASSOCIATION OF VITAMIN D STATUS WITH PANCREATIC EXOCRINE FUNCTION AND BIOCHEMICAL ABNORMALITIES IN CHRONIC PANCREATITIS

Background. Chronic pancreatitis (CP) is a progressive inflammatory disease of the pancreas characterized by irreversible structural changes and impaired exocrine function. Exocrine pancreatic insufficiency leads to disturbances in digestion and absorption of nutrients, especially fats and fat-soluble vitamins, including vitamin D. The relationship between serum calcidiol [25-hydroxyvitamin D, 25(OH)D] levels, pancreatic function, biochemical parameters, and digestive disorders in CP remains insufficiently investigated. Objective. To assess serum 25(OH)D levels in patients with chronic pancreatitis and determine their association with biochemical parameters, pancreatic exocrine function, and coprological abnormalities. Materials and Methods. The study included 94 patients with chronic pancreatitis and 15 healthy controls. Serum 25(OH)D levels were measured, and patients were classified according to vitamin D status. Clinical examination, biochemical blood analysis, fecal pancreatic elastase-1 (FE-1) assessment, and coprological evaluation were performed to determine digestive function, malabsorption signs, and nutrient absorption disorders. Results. Vitamin D insufficiency and deficiency were frequently observed in patients with chronic pancreatitis. Reduced 25(OH)D levels were associated with increased erythrocyte sedimentation rate, decreased total protein levels, and elevated total bilirubin concentrations. Lower vitamin D status was accompanied by reduced fecal pancreatic elastase-1 activity, indicating a relationship between vitamin D deficiency and pancreatic exocrine insufficiency. Patients with decreased 25(OH)D levels demonstrated more frequent steatorrhea, amylorrhea, intestinal dysbiosis, and impaired absorption of fat-soluble vitamins, B-group vitamins, calcium, and magnesium. Conclusion. Serum calcidiol [25(OH)D] concentration is associated with clinical, biochemical, and functional characteristics of chronic pancreatitis. Vitamin D status may serve as an additional marker for evaluating nutritional disorders and exocrine pancreatic insufficiency. Monitoring and correction of vitamin D deficiency may improve the comprehensive management of patients with chronic pancreatitis.