Does antioxidants supplementation improve pancreatic functions in chronic pancreatitis?

Chronic pancreatitis patients taking antioxidants (AO) supplementation show a sustained increase in blood levels of AO, but no additional benefit is seen on endocrine and exocrine functions, markers of fibrosis, oxidative stress (OS) and inflammation, nutritional status, pain, and quality of life (QOL) when compared with those on placebo, according to a study.

“AO supplementation in chronic pancreatitis has been evaluated for pain, [b]ut it is not clear whether AO in chronic pancreatitis has an effect on pancreatic functions and other clinical outcomes,” the investigators said.

To evaluate the effect of AO on endocrine function, a double-blind placebo-controlled randomized pilot study was conducted. A total of 107 patients with chronic pancreatitis were randomly assigned to receive either daily combined AO or placebo for 6 months. Improvement in endocrine function, using the Homeostasis Model Assessment-Insulin Resistance, was the primary outcome.

Secondary outcomes were as follows: improvement in C-peptide, Quality Insulin Sensitivity Check Index, exocrine pancreatic function (faecal elastase), surrogate markers of fibrosis (platelet-derived growth factor BB, transforming growth factor-β1, α-smooth muscle actin), QOL, pain, nutritional status, markers of OS, AO status and inflammation.

Patients in the AO group, compared with those on placebo, had an increase in levels of serum selenium (107.2±26.9 to 109.7±26.9 vs 104.1±28.6 to 124.0±33.6 μg/L; p=0.022) and serum vitamin E (0.58 to 0.66 vs 0.63 to 1.09 mg/dL; p=0.001). There were no significant between-group differences seen in any of the primary or secondary outcome measures.

“Further larger studies with adequate sample size are required,” the investigators said.