Hardt Philip D, Hauenschild Annette, Nalop Jens, Marzeion Axel M, Jaeger Clemens, Teichmann Joachim, Bretzel Reinhard G, Hollenhorst Manfred, Kloer Hans U
Third Medical Department and Policlinic, Giessen University Hospital, Giessen, Germany.
Pancreatology. 2003;3(5):395-402. doi: 10.1159/000073655. Epub 2003 Sep 24.
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.
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.
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.
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.
关于糖尿病患者胰腺外分泌功能障碍，已有众多使用直接或间接功能测试的报告。粪便弹性蛋白酶1浓度（FEC）的测定已被用作不同患者群体中胰腺外分泌疾病的筛查工具，这表明糖尿病患者中外分泌功能障碍的患病率很高。在本研究中，我们有机会研究1000多名糖尿病患者，以证实近期在较小群体中的观察结果。
采用酶联免疫吸附测定法（ELISA）测量323例1型糖尿病患者和697例2型糖尿病患者的FEC。排除有酗酒、胃肠道手术、癌症或炎症性疾病史的受试者。使用标准病例报告表记录糖尿病病史和临床数据。
共研究了1021例患者（女性334例，男性687例；平均年龄50岁；平均糖尿病病程11年；糖尿病发病平均年龄39岁）。FEC正常（>200μg/g）的患者占59.3%，严重降低（<100μg/g）的患者占22.9%。1型和2型患者之间以及胰岛素治疗和非胰岛素治疗患者之间存在显著差异。此外，FEC分别与糖尿病病程、糖尿病发病年龄和体重指数之间存在弱关联。
我们可以证实，1型和2型糖尿病患者均有较高患病率的胰腺外分泌功能病理改变。外分泌功能不全似乎与内分泌衰竭的早发、长期糖尿病和低体重指数水平相关。
