Piciucchi Matteo, Capurso Gabriele, Archibugi Livia, Delle Fave Martina Maria, Capasso Marina, Delle Fave Gianfranco
Digestive and Liver Disease Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy.
Int J Endocrinol. 2015;2015:595649. doi: 10.1155/2015/595649. Epub 2015 Mar 29.
Pancreas is a doubled-entity organ, with both an exocrine and an endocrine component, reciprocally interacting in a composed system whose function is relevant for digestion, absorption, and homeostasis of nutrients. Thus, it is not surprising that disorders of the exocrine pancreas also affect the endocrine system and vice versa. It is well-known that patients with chronic pancreatitis develop a peculiar form of diabetes (type III), caused by destruction and fibrotic injury of islet cells. However, less is known on the influence of diabetes on pancreatic exocrine function. Pancreatic exocrine insufficiency (PEI) has been reported to be common in diabetics, with a prevalence widely ranging, in different studies, in both type I (25-74%) and type II (28-54%) diabetes. A long disease duration, high insulin requirement, and poor glycemic control seem to be risk factors for PEI occurrence. The impact of pancreatic exocrine replacement therapy on glycemic, insulin, and incretins profiles has not been fully elucidated. The present paper is aimed at reviewing published studies investigating the prevalence of PEI in diabetic patients and factors associated with its occurrence.
胰腺是一个具有双重功能的器官，兼具外分泌和内分泌成分，在一个复杂的系统中相互作用，该系统的功能与消化、吸收及营养物质的稳态相关。因此，外分泌性胰腺疾病也会影响内分泌系统，反之亦然，这并不奇怪。众所周知，慢性胰腺炎患者会发展出一种特殊形式的糖尿病（III型），由胰岛细胞的破坏和纤维化损伤所致。然而，关于糖尿病对胰腺外分泌功能的影响，人们了解较少。据报道，胰腺外分泌功能不全（PEI）在糖尿病患者中很常见，在不同研究中，其在I型糖尿病（25%-74%）和II型糖尿病（28%-54%）中的患病率差异很大。病程长、胰岛素需求量大以及血糖控制不佳似乎是发生PEI的危险因素。胰腺外分泌替代疗法对血糖、胰岛素和肠促胰岛素水平的影响尚未完全阐明。本文旨在综述已发表的研究，这些研究调查了糖尿病患者中PEI的患病率及其发生相关因素。
