ARTERIAL STIFFNESS ASSOCIATES WITH MALNUTRITION IN HYPERTENSIVE PATIENTS WITH CONCOMITANT CHRONIC PANCREATITIS

Abstract

Objective: The association between pancreatitis and cardiovascular diseases remains incompletely understood. Malnutrition in chronic pancreatitis may be associated with an increase in arterial stiffness in hypertension. Objective: to evaluate interaction between malnutrition markers and arterial stiffness in patients with hypertension and chronic pancreatitis. Design and method: Methods: 70 non-diabetic patients with 1st degree hypertension with concomitant chronic pancreatitis (median age – 52,4 [43,8;63,7] years) were included in the study. We divided all included patients into two groups: 1st group – 41 patients with malnutrition, 2nd group – 29 patients without malnutrition. Standard laboratory blood tests, haematological parameters, lipid profile, glucose, renal and liver function tests, pancreatic fecal elastase-1, total protein, serum albumin, serum iron, vitamin 25(OH)D, serum zinc and magnesium detection were performed for all patients. The groups were comparable in terms of age, gender structure, functional state of the kidneys. Non-parametric methods were used for statistical data analysis. To determine the prognostic significance, the ROC analysis was performed. Significant differences were considered when the p-value was p<0.001 Results: In patients with a combined course of hypertension and chronic pancreatitis with established malnutrition, an increase in arterial stiffness was significantly more often compared to patients with normal nutritional status - 83% and 62%, respectively (p<0.001). A significantly lower level of brachial artery augmentation index was established by 43% (p<0.001) in the first group. It was established that patients with malnutrition had a significantly higher caritid-femoral pulse wave velocity by 17.5% (p<0.001). Correlations were established between brachial artery augmentation index and serum levels of zinc (R=0.63, p<0.001), magnesium (R=0.66, p<0.001), albumin (R=0.58, p<0.001), vitamin 25(OH)D (R=0.68, p<0.001) in patients with the combined course of hypertension and chronic pancreatitis. ROC analysis revealed that serum zinc level had an excellent diagnostic power for arterial stiffness in hypertensive patients with chronic pancreatitis (AUC = 0.910). Serum albumin had very good diagnostic power for arterial stiffness in hypertensive patients with chronic pancreatitis (AUC = 0.859). Conclusions: Arterial stiffness may be associated with malnutrition in hypertensive patients with concomitant chronic pancreatitis.