Chronic pancreatitis is associated with hyperhomocysteinemia and derangements in transsulfuration and transmethylation pathways.
OBJECTIVE
Homocysteine has been implicated in vascular dysfunction and thrombosis, as well as inflammatory conditions. This study was aimed to find out whether chronic pancreatitis (CP) is associated with hyperhomocysteinemia and derangements of transmethylation and transsulfuration pathways.


METHODS
We estimated homocysteine and its metabolites in 45 alcoholic CP patients, 45 tropical CP patients, and 48 healthy controls.


RESULTS
Significant increases in plasma total homocysteine and decreases in red blood cell folate, reduced glutathione, plasma methionine, cysteine, and urinary inorganic sulfate/creatinine ratio were observed in both alcoholic and tropical CP patients in comparison with healthy controls. Red blood cell glutathione and plasma cysteine levels were significantly lower in alcoholic than in tropical CP patients. However, plasma vitamin B12 levels were comparable between CP patients and controls. No significant differences in these parameters were observed between diabetic patients and nondiabetic patients. Multivariate regression analysis showed a significant negative correlation between homocysteine and folate (r = -0.415, P = 0.001) and a positive correlation between glutathione and cysteine levels (r = 0.37, P = 0.003).


CONCLUSIONS
Chronic pancreatitis is associated with hyperhomocysteinemia and derangements in transmethylation and transsulfuration pathways. Low folate levels observed in these patients seem to have a key role in this derangement.
Girish
Banavara Narasimhamurthy
BN
Department of Physiology, Amrita Institute of Medical Sciences, Kerala, India.
Vaidyanathan
Kannan
K
Rao
Nanjundarao Ananth
NA
Rajesh
Gopalakrishna
G
Reshmi
Shine
S
Balakrishnan
Vallath
V
D000328:Adult; D003404:Creatinine / Q000652:urine; D003545:Cysteine / Q000097:blood; D004912:Erythrocytes / Q000378:metabolism; D005260:Female; D005492:Folic Acid / Q000097:blood; D005978:Glutathione / Q000097:blood; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications*; D008297:Male; D008715:Methionine / Q000097:blood; D008745:Methylation; D008875:Middle Aged; D008954:Models, Biological; D015999:Multivariate Analysis; D019512:Pancreatitis, Alcoholic / Q000097:blood / Q000150:complications / Q000652:urine; D050500:Pancreatitis, Chronic / Q000097:blood / Q000150:complications* / Q000652:urine; D012044:Regression Analysis; D015398:Signal Transduction; D013431:Sulfates / Q000652:urine; D013455:Sulfur / Q000378:metabolism; D055815:Young Adult
D013431:Sulfates; D006710:Homocysteine; D013455:Sulfur; D005492:Folic Acid; D008715:Methionine; D003404:Creatinine; D005978:Glutathione; D003545:Cysteine