High prevalence of exocrine pancreatic insufficiency in diabetes mellitus. A multicenter study screening fecal elastase 1 concentrations in 1,021 diabetic patients.
BACKGROUND
There have been numerous reports on pancreatic exocrine dysfunction in diabetes mellitus using either direct or indirect function tests. The measurement of fecal elastase 1 concentrations (FEC) has been used as a screening tool for exocrine pancreatic disease in different patient groups indicating a high prevalence of exocrine dysfunction in diabetic populations. In this study we had the opportunity to study more than 1,000 diabetic patients to confirm recent observations in smaller populations.


METHODS
FEC were measured by ELISA in 323 patients with type 1 and 697 type 2 diabetes mellitus. Subjects with a history of alcohol abuse, gastrointestinal surgery, cancer or inflammatory diseases were not included. Diabetes history and clinical data were recorded using a standard case report form.


RESULTS
1,021 patients (334 female, 687 male; mean age 50 years; mean diabetes duration 11 years; mean age at onset of diabetes 39 years) were studied. FEC was normal (>200 microg/g) in 59.3% and severely reduced (<100 microg/g) in 22.9%. There were significant differences between type 1 and type 2 patients as well as between insulin-treated and non-insulin-treated patients. Furthermore, there were weak associations between FEC and diabetes duration, age at onset of diabetes and body mass index, respectively.


CONCLUSIONS
We could confirm that both type 1 and type 2 diabetic patients show pathological exocrine function in high prevalence. Exocrine insufficiency seems to be correlated to early onset of endocrine failure, long-lasting diabetes mellitus and low body mass index levels.
Hardt
Philip D
PD
Third Medical Department and Policlinic, Giessen University Hospital, Giessen, Germany.
Hauenschild
Annette
A
Nalop
Jens
J
Marzeion
Axel M
AM
Jaeger
Clemens
C
Teichmann
Joachim
J
Bretzel
Reinhard G
RG
Hollenhorst
Manfred
M
Kloer
Hans U
HU
D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000201:enzymology*; D004797:Enzyme-Linked Immunosorbent Assay; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis / Q000201:enzymology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000097:blood*; D010186:Pancreatic Function Tests; D015995:Prevalence; D013997:Time Factors
D010196:Pancreatic Elastase