DYSLIPIDEMIC CHANGES AS PREDICTORS OF THE PROGRATION OF EXOCRINE PANCREATIC INSUFFICIENCY IN PATIENTS WITH CHRONIC PANCREATITIS
DOI:
https://doi.org/10.11603/1811-2471.2019.v0.i2.10162Keywords:
chronic pancreatitis, lipid metabolism, exocrine pancreatic insufficiency, lipid distress syndromeAbstract
Chronic pancreatitis (CP) refers to nosologies, the incidence of which tends to global growth. A number of reasons have been identified that contribute to the appearance and progression of chronic inflammatory process at the level of the pancreas (P). One of these is dislipoproteinemia.
The purpose of the study: to analyze the features of lipid metabolism in patients suffering from CP with exocrine insufficiency.
Materials and methods: We examined 79 patients with signs of CP, who were on inpatient treatment at Khust district hospital during 2017-2018. According to the results, three study groups were formed. The first one consisted of patients with CP with a mild exocrine insufficiency (n = 50), the second - with moderate exocrine insufficiency (n = 29), to the third included practically healthy people (n = 23). To evaluate the exocrine function of the pancreas the level of elastase-1 in the feces was determined. Lipid homeostasis was evaluated for the following parameters: total cholesterol (TC), triglycerol (TG), low density lipoprotein cholesterol (LDL cholesterol), cholesterol of very low density lipoprotein (VLDL cholesterol), high density lipoprotein cholesterol (HDL cholesterol), and atherogenicity index (AI ). In addition, a correlation analysis of the effects of dyslipidemic disorders on the severity of the exocrine function was conducted.
The results of the research indicate the presence of lipid distress syndrome in patients with CP, which is manifested in the form of hypercholesterolemia, hypertriglycerolemia, increased LDL cholesterol concentrations, VLDL cholesterol and decrease HDL cholesterol. The dependence of exocrine insufficiency on the severity of dyslipidemic disorders was established.
Conclusions: in patients with CP, signs of lipid metabolism disorders were revealed and the influence of the latter on the exocrine function of the software was proved. Therefore, we consider it necessary to carefully study lipidograms in all patients with signs of chronic damage to the software.
References
Chang, Y.T., Chang, M.C., & Su T.C. (2008). Association of cystic brosis transmembrane conductance regulator (CFTR) mutation / variant / haplotype and tumor necrosis factor (TNF) promoter polymorphizm in hyperlipidemic pancreatitis. Clin. Chem., 54, 131-138. DOI: https://doi.org/10.1373/clinchem.2007.093492
Capurso, G., Archibugi, L., Stigliano, S. & Delle Fave, G. (2016). Epidemiology, clinical features and treatment of chronic pancreatitis: current knowledge and future perspectives. Recenti. Prog. Med., 6 (107), 328-336.
Litvitskiy, P.F. (2012). Rasstroystva lipidnogo obmena [Lipid metabolism disorders]. Voprosy sovremennoy pediatrii – Questions of Modern Pediatrics, 11 (6), 48-62 [in Russian].
Khristich, T.N. & Kendzerskaya, T.B. (2010). Podzheludochnaya zheleza pri metabolicheskom sindrome [Pancreas with metabolic syndrome]. Eksperementalnaya klinicheskaya gastroenterologiya – Experimental Clinical Gastroenterology, 8, 83-91 [in Russian].
Tsuang, W., Navaneethan, U., Ruiz, L., Palascak, J.B. & Gelrud, A. (2009). Hypertriglyceridemic pancreatitis: Presentation and manangment. Am. J. Gastroenerolog., 104, 984-991. DOI: https://doi.org/10.1038/ajg.2009.27
Babinets, L.S. & Mihenko, L.M. (2014). Dyslipidni rozlady u klinitsi khronichnoho pankreatytu; patohenez, diahnostyka, mozhlyvosti korektsii [Dislipid disorders in the clinic of chronic pancreatitis; pathogenesis, diagnostics, correction possibilities]. Novyny medytsyny ta farmatsii. Hastroenterolohiia – News of Medicine and Pharmacy. Gastroenterology, 489. Retrieved from: http://www.mif-ua.com/archive/article/21849 [in Ukrainian].
Petukhov, V.A. (2003). Diagnostika i printsipy lecheniya [Lipid distress syndrome. Diagnosis and treatment guidelines]. Moscow: VEDI [in Russian].
Khristich, T.N., Pishak, V.P. & Kendzerskaya, T.B. (2006). Khronicheskiy pankreatit: nereshennye problemy [Chronic pancreatitis: unsolved problems]. Сhernivtsi [in Russian].
Ferfetska, K.V. & Fediv, O.I. (2013). Rol metabolichnoho syndromu v rozvytku khronichnoho pankreatytu (ohliad literatury) [The role of metabolic syndrome in the development of chronic pancreatitis (review of literature)]. Bukovynskyi medychnyi visnyk – Bukovinian Medical Bulletin, 17, 174-178 [in Ukrainian].
Kimura, W. & Mossner, J. (1996). Role of hypertriglyceridemia in the patogenesis of experimental acute pancreatitis in rats. Int. J. Pancreatol., 20, 177-184. DOI: https://doi.org/10.1007/BF02803766
