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Amino Acid Malnutrition in Patients With Chronic Pancreatitis and Pancreatic Carcinoma

Objectives: Chronic pancreatitis (CP) and pancreatic cancer (CA) have been associated with intestinal malabsorption and inflammation. However, little is known about the changes in amino acid metabolism in such patients. Methods: The circulating amino acid levels were determined in 12 patients with CP, 12 CA patients, and 12 controls. Results: Total amino acid concentrations were 2850 ± 71 &mgr;mol/L in controls, 2640 ± 96 &mgr;mol/L in CP patients, and 2210 ± 123 &mgr;mol/L in CA patients (P < 0.001). In CP patients, significant reductions in the concentrations of citrulline, &ggr;-aminobutyric acid, taurine, and aspartic acid were found (P < 0.05), whereas in CA patients, the levels of phosphoethanolamine, &ggr;-aminobutyric acid, aspartic acid, taurine, arginine, threonine, alanine, citrulline, and tryptophan were reduced. There was a significant inverse relationship between the total amino acid levels and the white blood cell counts (r = −0.44, P = 0.008). Conclusions: Both patients with CP and with CA exhibit alterations in amino acid levels. The mechanisms underlying these defects may involve intestinal malabsorption as well as systemic inflammation. Providing selective amino acid supplementation to such patients may minimize the excess morbidity and mortality associated with protein malnutrition.