Functional Features of the Pancreas during Chronic Pancreatitis
Journal Title: Гастроентерологія - Year 2016, Vol 3, Issue 61
Abstract
Aim of study: to identify functional status of pancreas in patients with chronic pancreatitis depending on the stage of fibrotic transformation and activity of parenchymal inflammation. Materials and methods. The preoperative laboratory results and the data of morphological study performed on biopsies obtained during surgery in 88 patients with complications of chronic pancreatitis (CP) were compared. According to morphological study of pancreatic biopsies, the early pancreatic parenchymal fibrosis (I–II degree) has been diagnosed in 31 cases (35.2 %), late fibrosis (III–IV degree) — in 57 (64.8 %) cases. Results. Active parenchymal inflammation at early and late stages of pancreatic fibrosis are associated with changes in pancreatic secretion and intracellular activation of pancreatic enzymes, leading to autodigestion and release of these enzymes from acinar cells into the blood, which has been confirmed by an increase of trypsin and amylase activity in blood compared with inactive inflammation. At late stages of fibrosis reduction of fecal elastase‑1 (161.7 ± 4.8) mg/g was observed in 73.9 % of patients. Reverse correlation has been found between fibrotic transformation of pancreatic parenchyma and the level of fecal elastase‑1 (r = –0.46; p = 0.05), i.e. progressing fibrotic transformation of pancreas leads to reduced exocrine function. Correlation analysis showed that the progression of fibrotic transformation violates carbohydrate metabolism — a direct correlation with glycosylated hemoglobin (r = 0.496; p = 0.05), namely, the endocrine secretion deficiency. Novelty in science. The pancreas functioning was studied depending on the inflammation activity and stage of fibrosis transformation of its parenchyma at chronic pancreatitis. The active inflammation of the pancreas was found to be accompanied by significant activation of pancreatic enzymes (significant increase in blood amylase and trypsin activity), which causes the progression of fibrotic transformation of pancreas in CP. Conclusions. Progression of fibrotic transformation of the pancreatic parenchyma in CP leads to deterioration of the exocrine pancreatic function, as defined by a decrease in the level of fecal elastase‑1 in case of late fibrosis of the pancreas and to the deterioration of endocrine pancreatic function, as manifested by impaired fasting glucose metabolism both at early and late stages of fibrosis, the development of pancreatogenic type II diabetes at the early stages of pancreatic fibrotic transformation, insulin resistance and type I diabetes at later stages of pancreatic fibrotic transformation.
Authors and Affiliations
B. F. Shevchenko, A. M. Babiy, O. М. Tatarchuk, V. A. Makarchuk, V. E. Kudryavtseva
Keywords
Related Articles
- EP ID EP210079
- DOI 10.22141/2308-2097.3.61.2016.79157
- Views 88
- Downloads 0
Functional constipation at a young age. Place of macrogol 4000 (Forlax) in the treatment
Background. Considering the wide prevalence of functional constipation (FC) at a young age, we set ourselves the task of comparing the effectiveness of osmotic laxative macrogol 4000 (Forlax) in the treatment of FC in ad...
Peculiarities of Vegetative Regulation in Patients with Chronic Inflammatory Bowel Diseases Associated with Anemic Syndrome
Vegetative tone, vegetative reactivity and vegetative providing of activity were studied in 38 patients with ulcerative colitis (UC) and 15 patients with chronic colitis (CC) associated with anemic syndrome. 36 patients...
Dysfunction of the biliary tract in children: traditional approaches and new postulates
Digestive system diseases take one of the leading places in the structure of somatic pathology of childhood. Functional disorders of the biliary tract is a set of clinical symptoms, which developed as a result of motor-t...
Clinical and Pathogenetic Features of Nonalcoholic Fatty Liver Disease in Patients with Bronchial Asthma and Obesity
Due to comorbidity of bronchial asthma (BA) and obesity, there occurs the formation of nonalcoholic fatty liver disease (NAFLD), in which changes of pathogenic links of the disease are observed. Objective of the study: t...
Lactose maldigestion in the formation of insulin resistance in obese children with various lactase gene genotypes and methods of treatment
Background. In recent year, the occurrence of obesity and its complicated course increases with epidemic speed, especially among children living in large cities, and the causes of this pathomorphosis remain understudied....