The spectrum of pancreatic exocrine and endocrine (beta-cell) function in tropical calcific pancreatitis.
Exocrine pancreatic marker (immunoreactive-trypsin) and endocrine Beta-cell function (plasma insulin and C-peptide during an oral glucose tolerance test) were studied in 40 subjects with tropical-calcific-pancreatitis [seven non-diabetic, seven with impaired-glucose-tolerance and 26 diabetic (fibro-calculous-pancreatic-diabetes)]. In non-diabetic and impaired-glucose-tolerance subjects there was evidence of active pancreatitis in some and exocrine function was partially preserved. Fibro-calculous-pancreatic-diabetic subjects showed severely diminished exocrine pancreatic function; none showed 'pancreatitic' elevation of immunoreactive-trypsin. Beta-cell function was preserved in non-diabetic and impaired-glucose-tolerance subjects; diabetic subjects showed variable Beta-cell function but it was severely diminished in more than 75%. Immunoreactive-trypsin and C-peptide were directly correlated (rs = 0.55, p less than 0.01). This cross sectional study demonstrates, for the first time, that the Beta-cell loss in tropical-calcific-pancreatitis is related to the exocrine loss. It suggests that diabetes in tropical-calcific-pancreatitis is either secondary to pancreatitis or that a common factor(s) acts simultaneously on both components.
Wellcome Diabetes Study, King Edward Memorial Hospital, Pune, India.
C S
CS
Yajnik
K M
KM
Shelgikar
R A
RA
Sahasrabudhe
S S
SS
Naik
V R
VR
Pai
K G
KG
Alberti
T D
TD
Hockaday
A
A
Katrak
P
P
Dandona
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood / Q000378:metabolism; D002648:Child; D002908:Chronic Disease; D003920:Diabetes Mellitus / Q000097:blood / Q000503:physiopathology*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007194:India; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D000078790:Insulin Secretion; D007515:Islets of Langerhans / Q000378:metabolism*; D008297:Male; D010179:Pancreas / Q000201:enzymology*; D010195:Pancreatitis / Q000097:blood / Q000503:physiopathology*; D012016:Reference Values; D014329:Tropical Climate; D014357:Trypsin / Q000097:blood / Q000378:metabolism*
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D014357:Trypsin