There are no studies comparing some of the most important markers, such as
vitamin D,
parathormone,
osteocalcin, bone
alkaline phosphatase, and
calcium, in patients with chronic benign and malignant
pancreatic diseases. Our objective was to comparatively evaluate
serum markers of bone metabolism in patients with
chronic pancreatitis and in those with ductal pancreatic
adenocarcinoma. Sixty-three consecutive subjects were studied: 30 patients with a firm diagnosis of
chronic pancreatitis and 33 having histologically confirmed pancreatic
adenocarcinoma. Serum
25-hydroxyvitamin D, bone
alkaline phosphatase,
osteocalcin,
parathormone, and
calcium were determined using commercially available kits. Taking into consideration the clinical variables of all 63 patients studied,
25-hydroxyvitamin D was inversely correlated with only the body mass index (P = 0.007), whereas it was not correlated with age (P = 0.583) or fecal elastase-1 concentrations (P = 0.556). Regarding the other substances studied,
parathormone was positively correlated with only the age of the patients (P = 0.015). Of the 5 substances studied, only bone alkaline
phosphates were significantly different (P < 0.001) between patients with
chronic pancreatitis and those with pancreatic ductal
adenocarcinoma. Within the 2 groups of patients, the 23 patients with
chronic pancreatitis without
diabetes mellitus had serum concentrations of
25-hydroxyvitamin D significantly lower (P = 0.045) than those with
chronic pancreatitis having
diabetes mellitus, whereas smokers with pancreatic ductal
adenocarcinoma had serum concentrations of
calcium significantly higher (P < 0.001) as compared to nonsmokers. Altered bone metabolism seems to be associated with
chronic diseases of the pancreas; however, the mechanism should be better elucidated.