title: [Early carbohydrate metabolism dysfunction in chronic pancreatitis. Relation with the exocrine pancreatic function].
abstract: BACKGROUND
  The relationship between endocrine and exocrine dysfunction in chronic pancreatitis (CP) is controversial. Our goals were to evaluate the disturbances of carbohydrate metabolism in relation to the degree of exocrine insufficiency, to compare the usefulness of oral glucose tolerance test (OGTT) versus fasting blood glucose and to investigate the degree of exocrine and endocrine dysfunction according to the duration of CP.
  
  
  METHODS
  73 patients with CP were studied. Pancreas exocrine and endocrine status was evaluated by secretin-CCK test (SCT), fecal fat analysis and OGTT.
  
  
  RESULTS
  Out of 8 patients with normal SCT, 4 had an abnormal glucose metabolism with diabetes in 2 of them. Out of 50 patients with moderate exocrine insufficiency, there was an abnormal fecal fat excretion in 20%, an endocrine dysfunction in 54% and diabetes in 40%. All patients with severe dysfunction of the exocrine pancreas were diabetics. The OGTT test demonstrated that 42% of patients with normal fasting blood glucose had an abnormal glucose metabolism. Mean evolution time of CP was shorter in patients with endocrine dysfunction than in those with steatorrhea.
  
  
  CONCLUSIONS
  As far as functional exocrine status is concerned, in chronic pancreatitis there is a higher proportion of patients with glucose metabolism dysfunction than with abnormal fecal fat excretion. Carbohydrate metabolism dysfunction can be demonstrated by OGTT in a large proportion of patients with normal fasting blood glucose. In patients with CP, hydrocarbonate dysfunction seems to develop earlier than abnormal fecal fat excretion.
authors.affiliation: Servicios de Hígado y Páncreas, Hospital Clínico Universitario, Facultad de Medicina, Valencia. aparsi-lui@gva.es
authors.forename: L
authors.initials: L
authors.lastname: Aparisi Quereda
authors.forename: L
authors.initials: L
authors.lastname: Sabater Ortí
authors.forename: J
authors.initials: J
authors.lastname: Calvete Chornet
authors.forename: B
authors.initials: B
authors.lastname: Camps Vilata
authors.forename: J
authors.initials: J
authors.lastname: Sastre Belloch
authors.forename: D
authors.initials: D
authors.lastname: Bautista Rentero
authors.forename: J M
authors.initials: JM
authors.lastname: Rodrigo Gómez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D002908:Chronic Disease; D003920:Diabetes Mellitus / Q000378:metabolism; D005243:Feces / Q000737:chemistry; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008055:Lipids / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000378:metabolism*; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D008055:Lipids