Assessment of Gut Microbiota in Chronic Pancreatitis Depending on the Presence of Diabetes mellitus

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Almost 15% of persons from 40 to 75 years old suffer from chronic pancreatitis (CP) in combination with metabolic syndrome (MS). Such patients are diagnosed with impaired glucose tolerance or type 2 diabetes mellitus (DM), abdominal obesity, dyslipidemia, arterial hypertension, hyperuricemia, microalbuminuria, etc. The objective: to determine the state of microbiocenosis (MBC) of the colon in CP depending on the presence of concomitant type 2 DM. Materials and methods. 137 outpatient patients with CP and with/without type 2 DM participated in the study. The study group included 112 patients with CP without exacerbation and with comorbid type 2 DM (compensation/subcompensation stage). The comparison group included 25 patients with isolated CP without exacerbation. Patients underwent bacteriological examination of stool with counting of the number of lacto- and bifidobacteria colonies, opportunistic microflora, Escherichia coli, hemolytic and other pathological microorganisms (staphylococci, fungi, etc.) according to a modern modification of the R. V. Epshtein-Litvak and F. L. Vilshanska method. Results. In the group of patients with CP, dysbiosis disorders were found in 72.0% of patients, and with comorbidity of CP and type 2 DM – in 84.8% of patients. In case of comorbidity, colon dysbiosis was deeper than in isolated CP: intestinal dysbiosis of degree I was determined in 56.3% of patients versus 48.0%, and intestinal dysbiosis of degree II was found in 28.5% of patients versus 24.0%. It has been proven that the presence of concomitant type 2 DM aggravated the degree of intestinal dysbiosis by 1.83 times. The results of assessing the state of disorders of colon microflora parameters and the severity of intestinal dysbiosis indicate the aggravating nature of comorbid type 2 DM in CP. Conclusions. In 72.0% of patients with CP, dysbiotic disorders of the large intestine of I–II degree were established, while in cases of combined CP and type 2 DM – in 84.8%. In the presence of comorbidity, colon dysbiosis was deeper than in isolated CP: I degree of intestinal dysbiosis was found in 56.3% of patients versus 48.0%, respectively, and II degree of intestinal dysbiosis was determined in 28.5% of patients versus 24.0%. It has been proven that the presence of concomitant type 2 DM aggravated the degree of intestinal dysbiosis by 1.83 times (p<0.0001). At the same time, there was a significant decrease by 1 order of magnitude in the content of lacto- and bifidobacteria, an increase in the amount of E. coli and lactose-negative E. coli by 1.52 and 2.59 times, respectively, as well as an increase in the content of Candida, Staphylococcus aureus, hemolytic and opportunistic microorganisms – by 2.56; 2.50; 2.69 and 2.94 times, respectively.