Comparative Analysis of the Structure and Function of the Pancreas in Patients with a Combination of Chronic Pancreatitis and Metabolic Syndrome

Abstract

Metabolic syndrome (MS) is the most urgent problem of modern medicine, which is associated with an unhealthy lifestyle. This is a complex metabolic disorder based on insulin resistance and compensatory hyperinsulinemia. MS is a risk factor for the development of a significant number of various diseases. The objective: to determine the structural and functional state of the liver and pancreatic gland (PG) in patients with chronic pancreatitis (CP) depending on the presence of MS. Materials and methods. 137 patients with CP of biliary genesis (CBP) were included in the study. Patients were divided into two groups: the 1st group – 22 persons with isolated CBP, the 2nd group – 115 patients with CBP+MS. The control group included 20 practically healthy subjects. The age of the study participants ranged from 30 to 71 years. The presence of MS was determined, the state and structure of the PG and liver were examined. Results. A statistically significant higher content of HbA1c was determined in patients with CBP and MS compared to the group of patients with only CBP (6.10±0.14% vs. 5.47±0.15%). A significantly higher blood glucose level was found in the patients with CBP+MS (5.99±0.29 mmol/l vs. 5.31±0.12 mmol/l) compared to patients with CBP. A significantly higher level of the HOMA index was also determined in the group of patients with CBP+MS compared to the CBP group (2.60±0.10 vs.1.84±0.09). A higher level of liver stiffness was found in patients with CBP compared to the control group. The indicator of fecal α-elastase in patients with CBP+MS was 114.52±2.79 mcg/g, which was significantly lower than that in the group of patients with CBP without MS (158.60±5.55 mcg/g). Conclusions. In the presence of MS in patients with chronic biliary pancreatitis, more significant structural disorders in the liver and pancreas were established in the direction of increased density according to shear wave elastometry. The results of the study demonstrated the aggravating effect of concomitant MS on the structural state of the liver and on the structural and functional state of the pancreas in patients with chronic biliary pancreatitis.