title: Association of faecal elastase 1 with non-fasting triglycerides in type 2 diabetes.
abstract: OBJECTIVE
  Intestinal absorption of esterified fatty acids depends on exocrine pancreatic function and influences plasma triglycerides levels. The aim was to investigate the association of reduced exocrine pancreatic function (low fecal elastase-1; FE1) with plasma triglycerides in type 2 diabetes and controls without diabetes.
  
  
  METHODS
  FE1 (μg/g stool) and non-fasting plasma triglyceride measurements were undertaken in 544 type 2 diabetes patients (age: 63 ± 8 years) randomly selected from diabetes registers in Cambridgeshire (UK), and 544 matched controls (age, sex, practice) without diabetes. Linear regression models were fitted using FE1 as dependent and log-triglycerides as independent variable adjusting for sex, age, body mass index, alcohol consumption, serum lipase, HbA1c, and smoking.
  
  
  RESULTS
  FE1 concentrations were lower (mean ± SD: 337 ± 204 vs. 437 ± 216 μg/g, p < 0.05) and plasma triglycerides were higher (geometric mean */: standard deviation factor: 2.2*/:1.9 vs. 1.6*/:1.8 mmol/l, p < 0.05) in type 2 diabetes compared to controls, respectively. Within the category of type 2 diabetes and controls separately, a 10% increase in plasma triglycerides was associated with 4.5 μg/g higher FE1 concentrations (p < 0.01) after adjusting for confounders. In contrast, in diabetes patients and controls with pathological FE1 (<100 μg/g), low FE1 levels were associated with high plasma triglycerides (significant only in controls).
  
  
  CONCLUSIONS
  Non-fasting triglycerides were positively related to FE1 in both type 2 diabetes and controls suggesting that impairment of exocrine pancreas function is influencing plasma triglycerides. Marked loss of exocrine pancreatic function had the opposite effect, resulting in higher levels of plasma triglycerides.
authors.affiliation: Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Auf'm Hennekamp 65, D-40225 Düsseldorf, Germany. Electronic address: rathmann@ddz.uni-duesseldrof.de.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rathmann
authors.affiliation: MediStatistica, Neuenrade, Germany.
authors.forename: Burkhard
authors.initials: B
authors.lastname: Haastert
authors.affiliation: AstraZeneca R&D, Mölndal, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Oscarsson
authors.affiliation: AstraZeneca R&D, Mölndal, Sweden.
authors.forename: Niklas
authors.initials: N
authors.lastname: Berglind
authors.affiliation: Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Lindkvist
authors.affiliation: MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Wareham
mesh_terms: D000368:Aged; D000428:Alcohol Drinking; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000201:enzymology / Q000453:epidemiology / Q000378:metabolism*; D004739:England / Q000453:epidemiology; D005243:Feces / Q000201:enzymology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D015228:Hypertriglyceridemia; D008049:Lipase / Q000097:blood; D008297:Male; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000032:analysis*; D010186:Pancreatic Function Tests; D012907:Smoking; D014280:Triglycerides / Q000097:blood*
chemical_list: D006442:Glycated Hemoglobin; D008049:Lipase; D010196:Pancreatic Elastase; D014280:Triglycerides
keywords: Cardiovascular disease; Chronic pancreatitis; Faecal elastase 1; Pancreatic exocrine dysfunction; Triglycerides; Type 2 diabetes