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High prevalence of exocrine pancreatic insufficiency in diabetes mellitus. A multicenter study screening fecal elastase 1 concentrations in 1,021 diabetic patients.

AbstractBACKGROUND:
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.
FINDINGS:
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.
INTERPRETATION:
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.
AuthorsPhilip D Hardt, Annette Hauenschild, Jens Nalop, Axel M Marzeion, Clemens Jaeger, Joachim Teichmann, Reinhard G Bretzel, Manfred Hollenhorst, Hans U Kloer, S2453112/S2453113 Study Group
JournalPancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] (Pancreatology) Vol. 3 Issue 5 Pg. 395-402 ( 2003) ISSN: 1424-3903 [Print] Switzerland
PMID14526149 (Publication Type: Journal Article, Multicenter Study)
CopyrightCopyright 2003 S. Karger AG, Basel and IAP
Chemical References
  • Pancreatic Elastase
Topics
  • Adult
  • Age Factors
  • Age of Onset
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Diabetes Complications
  • Diabetes Mellitus (enzymology)
  • Enzyme-Linked Immunosorbent Assay
  • Exocrine Pancreatic Insufficiency (diagnosis, enzymology, etiology)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Elastase (blood)
  • Pancreatic Function Tests
  • Prevalence
  • Time Factors

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