Department of Internal Medicine, Slovenj Gradec General Hospital, Gosposvetska 1, 2380 Slovenj Gradec, Slovenia.
Pancreatology. 2013 Jul-Aug;13(4):343-6. doi: 10.1016/j.pan.2013.05.010. Epub 2013 Jun 14.
Exocrine pancreatic insufficiency (EPI) can occur in patients with diabetes mellitus (DM). Incidence of EPI and its clinical significance remain poorly defined. The aim of our study was to determine whether exocrine pancreatic function is impaired in patients with DM.
One hundred and fifty consecutive patients, mean age 59.0 (± 12.0 years), with DM lasting at least 5 years were included in the study. We included 50 patients with type 1 DM (DM1), 50 insulin-treated patients DM type 2 (DM2-insulin) and 50 non-insulin treated patients with DM type 2 (DM2 no-insulin). Diagnosis of DM was established from health records, lasting 15.0 ± 9.9 years on average. EPI was diagnosed with a fecal elastase-1 concentration (FE1) of less than 200 μg/g (ELISA).
FE1 was reduced in 8 (5.4%) patients: mildly reduced (100-200 μg/g) in 4 patients (2.7%) and markedly reduced (<100 μg/g) in 4 patients (2.7%). Frequency of EPI was 3 in DM1, 5 in DM2(insulin) and none in DM2 (no-insulin) groups.
EPI in DM occurred less frequently than in previous studies, probably due to our strict exclusion criteria (age, alcohol intake).
外分泌胰腺功能不全（EPI）可发生于糖尿病（DM）患者中。EPI 的发生率及其临床意义仍未明确。本研究旨在确定 DM 患者的外分泌胰腺功能是否受损。
本研究纳入了 150 例连续患者，平均年龄 59.0（±12.0 岁），DM 病史至少 5 年。我们纳入了 50 例 1 型糖尿病（DM1）患者、50 例接受胰岛素治疗的 2 型糖尿病（DM2-胰岛素）患者和 50 例未接受胰岛素治疗的 2 型糖尿病（DM2-无胰岛素）患者。DM 的诊断依据病史，平均病程为 15.0±9.9 年。EPI 通过粪便弹性蛋白酶-1 浓度（FE1）<200μg/g（ELISA）进行诊断。
8 例（5.4%）患者的 FE1 降低：4 例（2.7%）轻度降低（100-200μg/g），4 例（2.7%）显著降低（<100μg/g）。EPI 在 DM1 中的发生率为 3 例，DM2-胰岛素为 5 例，DM2-无胰岛素组无 1 例。
与既往研究相比，DM 中的 EPI 发生率较低，可能是由于我们严格的排除标准（年龄、饮酒）所致。
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