Mechanisms of Glycemia regulation using the Gut Hormones system in patients with chronic pancreatitis
Study Objective: Search for diagnostic and prognostic individualised predictive biomarkers of pancreatogenic diabetes in laboratory diagnostics and/or in combination with clinical trials information. Study Design: Comparative study of groups of patients with chronic pancreatitis (CP) depending on blood glucose concentration and the level of associated gut hormones. Materials and Methods: 152 patients with CP aged 24 to 66 years old (97 males and 55 females) were examined. The patients were divided into two groups depending on fasting blood glucose levels. The first group included patients with blood glucose of ≥ 5.7 mmol/L (73 patients; males/females - 49/24) and a full-scaled picture of DM - 34 patients; the second group included those with glucose level of < 5.7 mmol/L (79 patients; males/females - 48/31), including 4 patients with occult pancreatogenic diabetes. Study Results: In the group with the high glucose level, calcification of pancreas was twice as common as in the low-glucose group. When the exocrine function was assessed (according to pancreatic elastase-1 level), group 1 showed statistically significant reduction vs. group 2. C-peptide was statistically significantly lower in group 1. The statistically significant rise in cholecystokinin and secretin values in group 1 found during the study may be associated with the compensatory mechanism due to hyperglycemia. Conclusion: It was found out during the study that calcification, duration of the disease, resections, and the disease severity promote pancreatogenic diabetes. With hyperglycemia, reduction in exocrine and endocrine pancreas secretion results in changes in the basal level of gut hormones: secretin and cholecystokinin.