[Pancreatic exocrine function in diabetes mellitus. Determination of fecal elastase]

Rev Med Chil. 2006 Apr;134(4):407-14. doi: 10.4067/s0034-98872006000400001. Epub 2006 May 25.
[Article in Spanish]

Abstract

Background: One of the complications of diabetes mellitus is the development of pancreatic exocrine insufficiency.

Aim: To study pancreatic exocrine function in diabetics patients.

Material and methods: Seventy two diabetic patients were included in the protocol, but two were withdrawn because an abdominal CAT scan showed a chronic calcified pancreatitis, previously undiagnosed. Fecal elastase was measured by ELISA and the presence of fat in feces was assessed using the steatocrit.

Results: Mean age was 60+/-12 years and 67 (96%) patients had a type 2 diabetes. Fecal elastase was normal (elastase >200 microg/g) in 47 (67%) patients, mildly decreased (100-200 microg/g) in 10 (14%) and severely decreased in 13 (19%). There was a significant association between elastase levels and time of evolution of diabetes (p=0.049) and between lower elastase levels and the presence of a positive steatocrit (p=0.042). No significant association was found between elastase levels and other chronic complications of diabetes such as retinopathy, nephropathy, neuropathy, microangiopathy or with insulin requirement.

Conclusions: One third of this group of diabetic patients had decreased levels of fecal elastase, that was associated with the time of evolution of diabetes. Patients with lower levels of elastase have significantly more steatorrhea. Among diabetics it is possible to find a group of patients with non diagnosed chronic pancreatitis.

Publication types

  • English Abstract

MeSH terms

  • Aged
  • Biomarkers / analysis
  • Body Mass Index
  • Case-Control Studies
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / enzymology*
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / enzymology*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Enzyme-Linked Immunosorbent Assay
  • Exocrine Pancreatic Insufficiency / enzymology*
  • Exocrine Pancreatic Insufficiency / physiopathology
  • Feces / enzymology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Elastase / analysis*
  • Pancreatic Function Tests
  • Pancreatitis, Chronic / enzymology
  • Pancreatitis, Chronic / physiopathology
  • Time Factors

Substances

  • Biomarkers
  • Pancreatic Elastase