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Insights into the development of alcoholic chronic pancreatitis at soweto, South Africa: a controlled cross-sectional study.
MedLine Citation:
PMID:  21499204     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: : We asked why so few working-class Africans of Soweto have chronic pancreatitis (CP) when alcoholism is the norm.
METHODS: : Twenty-one alcoholics with acute psychosis but normal pancreas were investigated for lifestyle, micronutrient status, electrophilic stress, and iron overload.
RESULTS: : Alcoholics consumed more ethanol daily than did 14 previously studied patients with CP (P = 0.003); cigarette usage was similar; both groups had even poorer vitamin C status than 14 healthy controls, and no participant had iron overload. The CP group had higher scores for exposure to occupational xenobiotics than did alcoholics (P < 0.05), with lower plasma glutathione (P = 0.047) and urinary inorganic sulfate (P = 0.009). Further analysis identified hyperhomocysteinemia in the alcoholic set, with lower vitamin B12 (P < 0.001), higher folic acid (P = 0.003), and similar vitamin B6 levels compared with controls.
CONCLUSIONS: : The transition from alcoholism to CP in Soweto is associated with occupational exposure to xenobiotics. Among detoxification systems that are strained thereby, glutathione and inorganic sulfate depend on methionine intake, which is ample in Sowetans, whereas vitamin C, which exerts a glutathione-sparing effect, is deficient. Hence, a daily tablet of vitamin C may enable community prophylaxis against the disease-but homocysteine status would need monitoring.
Authors:
Isidor Segal; Reid Ally; Linda P Hunt; Lance N Sandle; Johan B Ubbink; Joan M Braganza
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pancreas     Volume:  40     ISSN:  1536-4828     ISO Abbreviation:  Pancreas     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8608542     Medline TA:  Pancreas     Country:  United States    
Other Details:
Languages:  eng     Pagination:  508-16     Citation Subset:  IM    
Affiliation:
From the *Department of Medicine, Chris Hani Baragwanath Hospital, Johannesburg, South Africa; †School of Clinical Sciences, South Bristol, University of Bristol; ‡Department of Clinical Pathology, Trafford General Hospital, Manchester, UK; §Department of Chemical Pathology, University of Pretoria, Pretoria, South Africa; and ∥Department of Gastroenterology, Manchester Royal Infirmary, Manchester, UK.
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