School of Medicine, University of Auckland, Auckland, New Zealand.
School of Medicine, University of Auckland, Auckland, New Zealand.
Alcohol. 2019 May;76:1-10. doi: 10.1016/j.alcohol.2018.06.005. Epub 2018 Jun 28.
Alcohol-related pancreatitis is common and the gastrointestinal tract plays an important role in the regulation of pancreatic exocrine function. While the relationship between pancreatic proteolytic enzymes and insulin (as well as other pancreatic hormones) has been investigated in detail, little is known about the relationship between pancreatic proteolytic enzymes and gastrointestinal humoral factors. The aim of this study was to study the associations between trypsin, chymotrypsin, and a panel of gastrointestinal humoral factors in patients after an episode of alcohol-related versus non-alcohol-related pancreatitis.
Fasting venous blood samples were analyzed for trypsin, chymotrypsin, cholecystokinin, gastrin, ghrelin, gastrin-related peptide, neuropeptide Y, peptide YY, secretin, and vasoactive intestinal peptide. Linear regression analysis was used in three statistical models, adjusting for covariates (age, sex, ethnicity, smoking, exercise, body mass index, dysglycemia, recurrence of pancreatitis, duration of pancreatitis, and severity of pancreatitis).
The study included 21 patients with alcohol-related pancreatitis and 72 with non-alcohol-related pancreatitis. Gastrin, cholecystokinin, and vasoactive intestinal peptide were significantly associated with chymotrypsin in all three statistical models and resulted in a 1.06, 1.98, and 2.74 times higher chymotrypsin level in alcohol-related pancreatitis, respectively. Ghrelin was significantly associated with trypsin in all three statistical models and resulted in a 2.64 times higher trypsin level in alcohol-related pancreatitis. Other associations did not demonstrate a consistent significant pattern.
In alcohol-related pancreatitis, several gut-related peptides are significantly associated with pancreatic exocrine function. Further studies to investigate the effect of alcohol on the interaction between cholecystokinin (as well as gastrin, ghrelin, and vasoactive intestinal peptide) and pancreatic exocrine function are warranted.
酒精相关性胰腺炎很常见，胃肠道在调节胰腺外分泌功能方面起着重要作用。虽然已经详细研究了胰腺蛋白水解酶与胰岛素（以及其他胰腺激素）之间的关系，但对于胰腺蛋白水解酶与胃肠道体液因子之间的关系知之甚少。本研究旨在研究酒精性与非酒精性胰腺炎发作后患者的胰蛋白酶、糜蛋白酶与一系列胃肠道体液因子之间的关系。
分析空腹静脉血样中的胰蛋白酶、糜蛋白酶、胆囊收缩素、胃泌素、胃饥饿素、胃泌素相关肽、神经肽 Y、肽 YY、分泌素和血管活性肠肽。使用三种统计模型进行线性回归分析，调整协变量（年龄、性别、种族、吸烟、运动、体重指数、糖代谢异常、胰腺炎复发、胰腺炎持续时间和胰腺炎严重程度）。
该研究纳入了 21 例酒精性胰腺炎患者和 72 例非酒精性胰腺炎患者。在所有三种统计模型中，胃泌素、胆囊收缩素和血管活性肠肽与糜蛋白酶显著相关，分别使酒精性胰腺炎中的糜蛋白酶水平升高 1.06、1.98 和 2.74 倍。在所有三种统计模型中，胃饥饿素与胰蛋白酶显著相关，使酒精性胰腺炎中的胰蛋白酶水平升高 2.64 倍。其他关联没有表现出一致的显著模式。
在酒精相关性胰腺炎中，几种与肠道相关的肽与胰腺外分泌功能显著相关。需要进一步研究以探讨酒精对胆囊收缩素（以及胃泌素、胃饥饿素和血管活性肠肽）与胰腺外分泌功能相互作用的影响。
