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Pancreatic exocrine insufficiency, diabetes mellitus and serum nutritional markers after acute pancreatitis

World Journal of Gastroenterology 2014年第48期20卷 18432-18438页

作者： Miroslav Vujasinovic Bojan Tepes Jana Makuc Sasa Rudolf Jelka Zaletel Tjasa Vidmar Maja Seruga bostjan birsa Miroslav Vujasinovic Jana Makuc Tjasa Vidmar Department of Internal Medicine Slovenj Gradec General Hospital Slovenj Gradec 2380 Slovenia Abakus Medico Diagnostic Centre Rogaska Slatina 3250 Slovenia Department of Radiology University Medical Centre Maribor Maribor 2000 Slovenia Department of Endocrinology Diabetes and Metabolic Diseases University Medical Centre Ljubljana Ljubljana 1000 Slovenia Department of Internal Medicine Murska Sobota General Hospital Murska Sobota 9001 Slovenia Department of Internal Medicine Celje General Hospital Celje 3000 Slovenia

AIM:To investigate impairment and clinical significance of exocrine and endocrine pancreatic function in patients after acute pancreatitis(AP).METHODS:Patients with AP were invited to participate in the *** of AP was determined by the Atlanta classification and definitions revised *** exocrine insufficiency(PEI)was diagnosed by the concentration of fecal *** additional work-up,including laboratory testing of serum nutritional markers for determination ofmalnutrition,was offered to all patients with low levels of fecal elastase-1 *** A1c or oral glucose tolerance tests were also performed in patients without prior diabetes mellitus,and type 3c diabetes mellitus(T3c DM)was diagnosed according to American Diabetes Association ***:One hundred patients were included in the study:75%(75/100)of patients had one attack of AP and 25%(25/100)had two or more *** most common etiology was ***,moderately severe and severe AP were present in 67,15 and 18%of patients,*** mean time from attack of AP to inclusion in the study was 2.7 *** was diagnosed in 21%(21/100)of patients and T3c DM in14%(14/100)of *** all patients with PEI,at least one serologic nutritional marker was below the lower limit of normal.T3c DM was more frequently present in patients with severe AP(P=0.031),but was also present in some patients with mild and moderately severe *** was present in all degrees of severity of *** were no statistically significantly differences according to gender,etiology and number of AP ***:As exocrine and endocrine pancreatic insufficiency can develop after AP,routine follow-up of patients is necessary,for which serum nutritional panel measurements can be useful.

关键词： Acute pancreatitis Diabetes mellitus Pancreatic ex

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