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ORIGINAL RESEARCH article

Front. Med.
Sec. Gastroenterology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1446699
This article is part of the Research Topic Diagnosis and Management of Acute, Chronic, and Autoimmune Pancreatitis View all 7 articles

An intensified trans-sectoral nutritional intervention in malnourished patients with chronic pancreatitis improves diseases prognosis and identifies potential biomarkers of nutritional status

Provisionally accepted
Mats L. Wiese Mats L. Wiese 1Fabian Frost Fabian Frost 1Fatuma Meyer Fatuma Meyer 2Josefine Müller Josefine Müller 2Luzia Valentini Luzia Valentini 2Karen Rischmüller Karen Rischmüller 3Georg Lamprecht Georg Lamprecht 3Antje Steveling Antje Steveling 1Markus M. Lerch Markus M. Lerch 4Ali A. Aghdassi Ali A. Aghdassi 1*
  • 1 University Medicine Greifswald, Greifswald, Germany
  • 2 Neubrandenburg University of Applied Sciences, Neubrandenburg, Germany
  • 3 Rostock University Medical Center, Rostock, Germany
  • 4 Ludwig Maximilian University of Munich, Munich, Germany

The final, formatted version of the article will be published soon.

    Background: Malnutrition is a common complication in chronic pancreatitis and associated with reduced quality of life and life expectancy. Nutritional support is considered mandatory in malnourished patients with chronic pancreatitis but there is only scarce evidence on optimal treatment modalities and the efficacy of nutrition therapy. Here, we investigated the feasibility and efficacy of an intensified nutritional intervention in malnourished patients with chronic pancreatitis and aimed to identify suitable indicators for monitoring nutritional status.We performed a single-arm feasibility study, in which malnourished patients with chronic pancreatitis received an intensified trans-sectoral nutritional intervention for 6 months. Multimodal treatment comprised face-to-face dietary counselling, oral nutritional supplementation, and a complementary telephone-based nutrition and exercise coaching. Patients underwent follow-up examinations after 28, 90, and 180 days, when we assessed changes in anthropometric and body composition measures, muscle function, Chronic Pancreatitis Prognosis Score (COPPS), as well as blood parameters and intestinal microbiota composition.Results: Eleven out of 73 patients initially screened for study participation were enrolled in the trial of which 9 subjects (age (mean±SD): 56.2 (±14.8) years; male: 67%; alcoholic etiology: 44%) underwent the complete intervention. Patients gained a median of 5.3 kg (8.6%) body weight, including 1.6 kg skeletal muscle mass, and significantly increased gait speed (p < 0.001). Ameliorated nutritional status and muscle function were associated with increased blood levels of IGF-1 and cholinesterase as well as altered gut microbiota composition on the phyla and genera level. Moreover, significant improvements in COPPS indicated reduced disease severity after 90 and 180 days.Malnourished patients with chronic pancreatitis benefit from intensified nutritional therapy. Besides ameliorated nutritional status, a multimodal intervention can improve muscle function as well disease prognosis. Future studies are needed to prove superiority to standard-of-care and to validate potential biomarkers for prospective monitoring of nutritional status.

    Keywords: Malnutrition, Chronic pancreatitis, Nutrition Therapy, Diet, supplementation

    Received: 10 Jun 2024; Accepted: 26 Sep 2024.

    Copyright: © 2024 Wiese, Frost, Meyer, Müller, Valentini, Rischmüller, Lamprecht, Steveling, Lerch and Aghdassi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Ali A. Aghdassi, University Medicine Greifswald, Greifswald, Germany

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