Leptin and its correlation with exocrine and endocrine pancreatic function in idiopathic chronic pancreatitis: implications for pathophysiology.
OBJECTIVE
Leptin alters pancreatic exocrine and beta-cell secretion in animal studies. We hypothesized that leptin might be important in the pathogenesis of idiopathic chronic pancreatitis (ICP) and/or the development of diabetes in ICP.


METHODS
Fifty patients with ICP (25 with diabetes, 25 without diabetes) and 25 healthy controls were included in a prospective, case-control study. Fasting plasma leptin concentration was measured by enzyme-linked immunosorbent assay. Exocrine and endocrine pancreatic functions were assessed by fecal chymotrypsin and serum C-peptide, respectively. Anthropometric parameters and body fat mass (FM) were measured.


RESULTS
Patients with ICP (mean age, 30 years; 33 men) had significantly lower body mass index (19.5 +/- 2.6 kg/m2) and FM (10.6 +/- 4.2 kg) as compared with controls (body mass index, 21.7 +/- 4.1 kg/m2; FM, 19.0 +/- 16.6 kg; P < 0.01). Fecal chymotrypsin (median, 5.2 [range, 0.3-42.6] U/kg) and C-peptide (median, 1.7 [range, 0.2-9.5] ng/mL) were significantly lower in patients than in controls (12.9 [range, 2.5-33.0] U/kg and 3.5 [range, 0.3-10.3] ng/mL; P < 0.01). Plasma leptin concentration was slightly lower but statistically insignificant in patients with ICP (median, 4.0 [range, 2.0-62.5] ng/mL) as compared with controls (median, 5.0 [range, 2.0-63.0] ng/mL). Patients with and those without diabetes were also comparable with regard to their leptin concentration, pancreatic functions, and anthropometric parameters.


CONCLUSIONS
Leptin does not seem to have a pathophysiological role in either ICP or the development of diabetes in ICP.
Midha
Shallu
S
Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.
Singh
Siddharth
S
Sachdev
Vikas
V
Misra
Anoop
A
Garg
Pramod Kumar
PK
D000273:Adipose Tissue / Q000473:pathology; D000328:Adult; D000886:Anthropometry; D002096:C-Peptide / Q000032:analysis; D016022:Case-Control Studies; D002918:Chymotrypsin / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000209:etiology / Q000628:therapy; D005243:Feces / Q000201:enzymology; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D046790:Pancreas, Exocrine / Q000503:physiopathology; D050500:Pancreatitis, Chronic / Q000097:blood* / Q000209:etiology; D011446:Prospective Studies
D002096:C-Peptide; D020738:Leptin; D002918:Chymotrypsin