Clinical application of 13C-Hiolein breath test in assessing pancreatic exocrine insufficiency.
OBJECTIVE
To examine the feasibility and significance of 13C-Hiolein breath test in evaluating chronic pancreatitis-related exocrine insufficiency and efficacy of enzyme treatment.


METHODS
The 13C-Hiolein breath test was used in 8 healthy volunteers (group 1), 8 chronic pancreatitis (CP) patients without steatorrhea (group 2), and 8 CP patients with steatorrhea (group 3). To evaluate the function of pancreatic exocrine, 13CO2 was determined following 13C-Hiolein diet. The 13C-Hiolein test was repeated in group 3 after enzyme supplement therapy.


RESULTS
Administration of 13C-Hiolein diet resulted in significantly higher cumulative percent dose of 13C recovery per 6 h (cPDR/6 h) and maximal PDR (PDR(peak)) in the healthy controls (group 1) than the CP patients with steatorrhea (group 3) (11.22%+/-1.22% and 6.11%+/-0.59% vs 2.87%+/-0.73% and 1.53%+/-0.36%, respectively, both P<0.01). In the CP patients with steatorrhea (group 3), a repeated test after enzyme supplementation therapy showed a significant elevation of both cPDR/6 h and PDR(peak) (9.03%+/-0.84% and 2.33%+/-0.47%, both P<0.01 compared with those before enzyme treatment), but cPDR/6 h remained significantly lower than that in the healthy volunteers (group 1, P<0.05). Both cPDR and PDR(peak) in the CP patients without steatorrhea (group 2) were similar to those in the healthy controls (group 1, both P>0.05).


CONCLUSIONS
The results of 13C-Hiolein breath test well reflect fat metabolism status in CP patients, and the test can be used to monitor the efficacy of pancreatic enzymes therapy.
Department of Gastroenterology, Huashan Hospital, Fudan University, Shanghai 200040, China. sdy385@yahoo.com.cn
Da-Yu
DY
Sun
Yi-Bing
YB
Jiang
Lan
L
Rong
Shao-Jing
SJ
Jin
Weng-Zhang
WZ
Xie
D000328:Adult; D000368:Aged; D001944:Breath Tests; D002247:Carbon Isotopes; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000503:physiopathology*; D010195:Pancreatitis / Q000175:diagnosis* / Q000503:physiopathology; D045602:Steatorrhea / Q000175:diagnosis / Q000503:physiopathology; D014280:Triglycerides
D002247:Carbon Isotopes; D014280:Triglycerides; C417773:hiolein