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 study.Severity...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 study.Severity of AP was determined by the Atlanta classification and definitions revised in2012.Pancreatic exocrine insufficiency(PEI)was diagnosed by the concentration of fecal elastase-1.An 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 FE.Hemoglobin 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 criteria.RESULTS: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 attacks.The most common etiology was alcohol.Mild,moderately severe and severe AP were present in 67,15 and 18%of patients,respectively.The mean time from attack of AP to inclusion in the study was 2.7 years.PEI was diagnosed in 21%(21/100)of patients and T3c DM in14%(14/100)of patients.In 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 AP.PEI was present in all degrees of severity of AP.There were no statistically significantly differences according to gender,etiology and number of AP attacks.CONCLUSION: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.展开更多
文摘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 study.Severity of AP was determined by the Atlanta classification and definitions revised in2012.Pancreatic exocrine insufficiency(PEI)was diagnosed by the concentration of fecal elastase-1.An 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 FE.Hemoglobin 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 criteria.RESULTS: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 attacks.The most common etiology was alcohol.Mild,moderately severe and severe AP were present in 67,15 and 18%of patients,respectively.The mean time from attack of AP to inclusion in the study was 2.7 years.PEI was diagnosed in 21%(21/100)of patients and T3c DM in14%(14/100)of patients.In 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 AP.PEI was present in all degrees of severity of AP.There were no statistically significantly differences according to gender,etiology and number of AP attacks.CONCLUSION: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.
