Gastroenterology 1997 Jun;112(6):2048-55
Bacterial
lipase and high-fat diets in canine exocrine pancreatic insufficiency: a new
therapy of steatorrhea?
Suzuki
A, Mizumoto A, Sarr MG, DiMagno EP.
Gastroenterology
Research Unit, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905,
USA.
BACKGROUND
& AIMS: Nutrients and properties of lipases affect survival of lipolytic
activity during aboral gastrointestinal transit. Whether different doses and
formulations of bacterial lipase and diets affect steatorrhea
was tested in pancreatic-insufficient dogs. METHODS: A dose of 0-600,000 IU of
powdered and 135,000 and 300,000 IU of liquid bacterial lipase was given with
a standard meal to 5 dogs with ligated pancreatic ducts. In 4 dogs, 0 or
300,000 IU (normal 6-hour postprandial amount) of powder bacterial lipase was
also given with five meals containing 850 kcal with different nutrient caloric
densities (mixture design). Coefficients of fat absorption during 72-hour
fecal balance studies were used to assess treatments. RESULTS: With the
standard meal, powder bacterial lipase reduced steatorrhea in a dose-dependent
manner (P = 0.03), and 135,000 and 300,000 IU of the liquid form decreased
steatorrhea more than powder bacterial
lipase (P = 0.017 and 0.057, respectively). Coefficients of fat absorption
with 300,000 IU of powder bacterial lipase correlated (r2 = 0.79; P <
0.001) with increasing proportions of fat calories in diets. CONCLUSIONS:
Liquid bacterial lipase decreases steatorrhea more than powder, and 300,000 IU
of powder bacterial lipase ingested with high-fat meals corrects canine
pancreatic steatorrhea. The combination of adequate mixing of small amounts
(milligrams) of bacterial lipase and high-fat meals abolishes canine
steatorrhea and may abolish human pancreatic steatorrhea.
PMID:
9178698 [PubMed - indexed for MEDLINE]