Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Gastroenterology Department, Central Military Emergency University Hospital, 010825 Bucharest, Romania.
Biomolecules. 2022 Apr 21;12(5):618. doi: 10.3390/biom12050618.
Pancreatic exocrine and endocrine dysfunctions often come together in the course of pancreatic diseases as interdependent manifestations of the same organ. However, the mechanisms underlying the bidirectional connection of the exocrine and endocrine pancreas are not fully understood. In this review, we aimed to synthetize the current knowledge regarding the effects of several exocrine pancreatic pathologies on the homeostasis of β-cells, with a special interest in the predisposition toward diabetes mellitus (DM). We focused on the following pancreatic exocrine diseases: chronic pancreatitis, acute pancreatitis, cystic fibrosis, pancreatic cancer, pancreatic resections, and autoimmune pancreatitis. We discuss the pathophysiologic mechanisms behind the impact on β-cell function and evolution into DM, as well as the associated risk factors in progression to DM, and we describe the most relevant and statistically significant findings in the literature. An early and correct diagnosis of DM in the setting of pancreatic exocrine disorders is of paramount importance for anticipating the disease's course and its therapeutical needs.
胰腺外分泌和内分泌功能障碍通常在胰腺疾病的过程中同时出现，是同一器官相互依存的表现。然而，外分泌腺和内分泌胰腺之间双向连接的机制尚不完全清楚。在这篇综述中，我们旨在综合目前关于几种胰腺外分泌疾病对β细胞稳态影响的知识，特别关注其对糖尿病（DM）的易感性。我们重点介绍以下胰腺外分泌疾病：慢性胰腺炎、急性胰腺炎、囊性纤维化、胰腺癌、胰腺切除术和自身免疫性胰腺炎。我们讨论了影响β细胞功能和发展为 DM 的病理生理机制，以及进展为 DM 的相关危险因素，并描述了文献中最相关和最具统计学意义的发现。在胰腺外分泌疾病的背景下，早期和正确诊断 DM 对于预测疾病的进程和治疗需求至关重要。
