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.
Sun
Da-Yu
DY
Department of Gastroenterology, Huashan Hospital, Fudan University, Shanghai 200040, China. sdy385@yahoo.com.cn
Jiang
Yi-Bing
YB
Rong
Lan
L
Jin
Shao-Jing
SJ
Xie
Weng-Zhang
WZ
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