review of literature on clinical pancreatology - The Pancreapedia

the risk <strong>of</strong> pancreatic cancer. It was followed the participants in the NIH-AARP Diet andHealth Study from 1995/1996 through 2003. A baseline self-administered food frequencyquestionnaire was used to assess the dietary intake and exposure information. A total <strong>of</strong>1,151 exocrine pancreatic cancer cases were identified from 482,362 participants afterexcluding first-year <strong>of</strong> follow-up. There were no associations between glycemic index, total oravailable carbohydrates, gycemic load, and pancreatic cancer risk. Participants with high freefructose and glucose intake were at a greater risk <strong>of</strong> developing pancreatic cancer. Therewere no statistically significant interactions by body mass index, physical activity, or smokingstatus. The results do not support an association between glycemic index, total or availablecarbohydrate intake, and glycemic load and pancreatic cancer risk. The higher riskassociated with high free fructose intake needs further confirmation and elucidation [344].FructoseUsing fructose dehydrogenase-catalyzed conversion <strong>of</strong> d-fructose to 5-ket<strong>of</strong>ructose, followedby quantitation <strong>of</strong> MTT [3-(4,5-dimethylthiaze-syl)-2,5-diphenyltetrazolium bromide] formazanproduction by direct spectrophotometry, an assay to measure serum fructose concentrationwas developed, and assay sensitivity and specificity were tested. Validity <strong>of</strong> the assay wasconfirmed by gas chromatography-mass spectroscopy, and the assay was tested in healthysubjects and pancreatic cancer patients. The assay was highly specific, exhibiting no crossreactivitywith other sugars. Mean serum fructose concentration in fasting healthy volunteerswas 1.9 + 0.4 mM and after ingestion <strong>of</strong> a fructose and glucose-containing drink rose to 16.3+ 1.2 mM at 15 minutes and peaked at 30 minutes when serum fructose was 17.2 + 1.1 mM.Mean fasting serum fructose level was significantly higher at 5.7 + 2.5 mM in patients withpancreatic cancer than those with no pancreatic cancer. The fructose dehydrogenase-basedenzymatic assay correlated highly with gas chromatography-mass spectroscopic analysis <strong>of</strong>serum fructose with a correlation coefficient <strong>of</strong> 0.94. It was concluded that measurement <strong>of</strong>serum fructose concentration may provide insight into the relationship between refinedfructose intake and diseases including pancreatic cancer [345].Citrus fruitsThe purpose <strong>of</strong> one systematic <strong>review</strong> was to investigate the association between dietaryintake <strong>of</strong> citrus fruits and pancreatic cancer risk. The authors searched electronic databasesand the reference lists <strong>of</strong> publications <strong>of</strong> studies addressing diet and pancreatic cancer up toDecember 2007. All <strong>of</strong> the epidemiological studies that obtained individual data on dietaryintake <strong>of</strong> citrus fruits and presented risk estimates <strong>of</strong> the association between intake <strong>of</strong> citrusfruits and risk <strong>of</strong> pancreatic cancer were identified and included. Using general variancebasedmethods, study-specific odds ratios (ORs)/relative risk and associated confidenceinterval (CI)/SE for highest versus lowest intake <strong>of</strong> citrus fruits level were extracted from eacharticle. Nine articles including 4 case-control studies and 5 cohort studies proved eligible.Overall summary OR using random effect model suggested an inverse association in risk <strong>of</strong>pancreatic caner with intake <strong>of</strong> citrus fruits (summary odds ratio, 0.83) with largeheterogeneity across studies. It was concluded that pooled results from observational studiesshowed an inverse association between intake <strong>of</strong> citrus fruits and the risk <strong>of</strong> pancreaticcancer, although results vary substantially across studies, and the apparent effect isrestricted to the weaker study design (case-control studies) [346].PollutionTo describe the mortality pr<strong>of</strong>ile <strong>of</strong> the population resident in the polluted area <strong>of</strong> nationalconcern "Laguna di Grado e Marano" Friuli-Venezia-Giulia region, in the period 1997-2001and to examine mortality temporal trends between 1981 and 2001 a small-areaepidemiological study based on descriptive statistics, socioeconomic deprivation variables,