粪便中胰弹性蛋白酶水平作为糖尿病患者外分泌胰腺功能的标志物

Pancreatic Elastase Levels in Feces As A Marker of Exocrine Pancreatic Function in Patients With Diabetes Mellitus.

作者信息

Kangrga Ranka N, Ignjatović Svetlana D, Dragašević Mirjana M, Jovičić Snežana Ž, Majkić-Singh Nada T

机构信息

Center for Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia.

Center for Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia, Department for Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Serbia.

出版信息

Lab Med. 2016 May;47(2):140-8. doi: 10.1093/labmed/lmw015.

DOI:10.1093/labmed/lmw015

PMID:27069032

Abstract

OBJECTIVE

The measurement of pancreatic elastase (PE) in feces is used widely to screen for pancreatic exocrine insufficiency. The aim of our study was to evaluate the relationship of PE with residual beta cell secretion and metabolic control in patients with diabetes mellitus.

METHOD

We determined the presence of PE in specimens via enzyme-linked immunosorbent assay (ELISA), whereas serum fasting glucose, C-peptide, amylase, lipase, triglycerides, total 25(OH)-vitamin D, C-reactive protein (CRP), and hemoglobin A1c (HbA1c) concentrations were assayed using routine laboratory tests.

RESULTS

PE values in 48 patients with diabetes were significantly lower than in 24 healthy volunteers (P = 001). In one-third of participants with diabetes mellitus, PE were less than 200 µg per g, indicating pancreatic functional insufficiency. Among the patients in the cohort, PE correlated positively with C-peptide levels (P = 04), lipase (P = 009), CRP (P = 04), sex (P = 03), and BMI (P = 02) but not significantly with duration of diabetes (P = 81) or levels of HbA1c(P = 87), amylase (P = 06), total 25(OH)-vitamin D (P = 16), or triglycerides (P = 52).

CONCLUSION

Our results demonstrated a strong association of diabetes with low PE levels.

摘要

目的

粪便中胰腺弹性蛋白酶（PE）的检测被广泛用于筛查胰腺外分泌功能不全。我们研究的目的是评估糖尿病患者中PE与残余β细胞分泌及代谢控制之间的关系。

方法

我们通过酶联免疫吸附测定（ELISA）确定标本中PE的存在，而血清空腹血糖、C肽、淀粉酶、脂肪酶、甘油三酯、总25（OH）-维生素D、C反应蛋白（CRP）和糖化血红蛋白（HbA1c）浓度则使用常规实验室检测方法进行测定。

结果

48例糖尿病患者的PE值显著低于24名健康志愿者（P = 0.01）。在三分之一的糖尿病参与者中，PE低于每克200微克，表明胰腺功能不全。在该队列患者中，PE与C肽水平（P = 0.04）、脂肪酶（P = 0.09）、CRP（P = 0.04）、性别（P = 0.03）和BMI（P = 0.02）呈正相关，但与糖尿病病程（P = 0.81）或HbA1c水平（P = 0.87）、淀粉酶（P = 0.06）、总25（OH）-维生素D（P = 0.16）或甘油三酯（P = 0.52）无显著相关性。