[Pancreatic exocrine function in diabetes mellitus. Determination of fecal elastase].
BACKGROUND
One of the complications of diabetes mellitus is the development of pancreatic exocrine insufficiency.


OBJECTIVE
To study pancreatic exocrine function in diabetics patients.


METHODS
Seventy two diabetic patients were included in the protocol, but two were withdrawn because an abdominal CAT scan showed a chronic calcified pancreatitis, previously undiagnosed. Fecal elastase was measured by ELISA and the presence of fat in feces was assessed using the steatocrit.


RESULTS
Mean age was 60+/-12 years and 67 (96%) patients had a type 2 diabetes. Fecal elastase was normal (elastase >200 microg/g) in 47 (67%) patients, mildly decreased (100-200 microg/g) in 10 (14%) and severely decreased in 13 (19%). There was a significant association between elastase levels and time of evolution of diabetes (p=0.049) and between lower elastase levels and the presence of a positive steatocrit (p=0.042). No significant association was found between elastase levels and other chronic complications of diabetes such as retinopathy, nephropathy, neuropathy, microangiopathy or with insulin requirement.


CONCLUSIONS
One third of this group of diabetic patients had decreased levels of fecal elastase, that was associated with the time of evolution of diabetes. Patients with lower levels of elastase have significantly more steatorrhea. Among diabetics it is possible to find a group of patients with non diagnosed chronic pancreatitis.
Mancilla A
Carla
C
Secciones de Gastroenterología, Departamento de Medicina, Hospital Clínico, Universidad de Chile.
Hurtado H
Carmen
C
Tobar A
Eduardo
E
Orellana N
Ivonne
I
Pineda B
Pedro
P
Castillo M
Iván
I
Ledezma R
Rodrigo
R
Berger F
Zoltán
Z
D000368:Aged; D015415:Biomarkers / Q000032:analysis; D015992:Body Mass Index; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000201:enzymology* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000201:enzymology* / Q000503:physiopathology; D004797:Enzyme-Linked Immunosorbent Assay; D010188:Exocrine Pancreatic Insufficiency / Q000201:enzymology* / Q000503:physiopathology; D005243:Feces / Q000201:enzymology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000032:analysis*; D010186:Pancreatic Function Tests; D050500:Pancreatitis, Chronic / Q000201:enzymology / Q000503:physiopathology; D013997:Time Factors
D015415:Biomarkers; D010196:Pancreatic Elastase