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Zinc Metabolism in Patients with Exocrine Pancreatic Insufficiency

Division of Gastroenterology, Department of Medicine, Sinai Hospital of Baltimore, Baltimore, Maryland; and Department of Nuclear Medicine, National Institute of Health, Bethesda, Maryland

View larger version (15K): [in a new window]   Fig. 1. Percent intestinal absorption of Zn65 was measured in six patients with pancreatic insufficiency (PI), six alcoholic control subjects (AC), and 10 non-alcoholic control subjects (C).

View larger version (14K): [in a new window]   Fig. 2. Percent total body retention of zinc was compared in six patients with pancreatic insufficiency (x---x) to six alcoholic control subjects (o---o) after oral administration of Zn65. The percent retention of Zn65 in patients with pancreatic insufficiency tended to be lower as compared to controls, however the difference was not statistically significant.

View larger version (14K): [in a new window]   Fig. 3. Biological half life of Zn65 in five patients with exocrine pancreatic insufficiency (PI), and five alcoholic controls based on total body retention of radioactive Zinc (Zn65). There was no statistical difference between the two groups.

View larger version (13K): [in a new window]   Fig. 4. Mean (±SE) percent of 4-day cumulative excretion of Zn65 in feces in five patients with pancreatic insufficiency (hollow bar) and five alcoholic control subjects (solid bar) during four sequential periods (I, II, III and IV) after administration of radioactive zinc (Zn65). There was a significant reduction in percent excretion of Zn65 in patients compared to the control group (p<0.05) in the second 4-day period, suggesting reduced endogenous zinc excretion in patients with exocrine pancreatic insufficiency.

View larger version (16K): [in a new window]   Fig. 5. Mean (±SE) percent 4-day cumulative excretion of Zn65 in urine in five patients with pancreatic insufficiency (hollow bar) and five alcoholic control subjects (solid bar) during four sequential periods (I, II, III and IV) after administration of radioactive zinc (Zn65). Urinary excretion of Zn65 was significantly (p<0.05) higher in pancreatic disease patients as compared to the control subjects during the first and second 4-day period after oral administration of radioactive zinc.

View larger version (13K): [in a new window]   Fig. 6. Mean (±SE) daily zinc balance (mg/day) was calculated for 8 consecutive days in five patients with pancreatic insufficiency (hollow bar) and five alcoholic controls (solid bar). Although, no statistically significant difference was observed between the two groups, the magnitude of positive zinc balance in pancreatic disease patients (PI) was lower than the alcoholic control subjects (AC), and found to be negative on 2 days.

View larger version (13K): [in a new window]   Fig. 7. Mean (±SE) total zinc excretion in feces (mg/day) was measured in five patients with pancreatic insufficiency (PI)(x---x), and five alcoholic control subjects (AC)(o---o) for 8 days during a zinc balance study. There was no significant difference between two groups. Fecal zinc in this study represents non-absorbed dietary zinc, and endogenous zinc excretion.

View larger version (12K): [in a new window]   Fig. 8. Mean (±SE) concentration of zinc in feces (µg/g wet stool) was measured in five patients with pancreatic insufficiency (PI)(x---x) and five alcoholic controls (AC)(o---o) during an eight day balance study. There was no significant difference between two groups during the 8-day period of study.

View larger version (15K): [in a new window]   Fig. 9. Mean (±SE) zinc excretion in urine (mg/day) was measured in five patients with pancreatic insufficiency (PI)(x---x) and five alcoholic controls (AC)(o---o) during an 8-day zinc balance study. There was 2 to 4 fold increase in urinary excretion in patients with pancreatic insufficiency as compared to alcoholic controls AC, which was statistically significant (*p<0.05).

View larger version (16K): [in a new window]   Fig. 10. Mean (±SE) concentration of zinc in urine (µg/ml) was measured in five patients with pancreatic insufficiency (PI)(x---x) and five alcoholic controls (AC)(o---o) during an 8-day zinc balance study. Mean urinary zinc concentration in patients with pancreatic disease was significantly higher (p<0.05) than in alcoholic controls.