Diabetes mellitus type 3c screening by patients with chronic pancreatitis

Abstract

Aims: To investigate the association between fecal elastase-1 (FE1) and non-fasting triglycerides in patients with T2D and controls. Patients & methods: Data from 544 patients with T2D (age: 63 ±8 years) randomly selected from diabetes registers in Cambridgeshire (UK), and 544 matched controls (age, sex, practice) without diabetes were retrospectively analyzed. FE1 and non-fasting triglycerides were centrally determined. Linear regression models were fitted using FE1 as dependent and log-triglycerides as independent variable adjusting for sex, age, body mass index, alcohol consumption, serum lipase, HbA1c, and smoking. Results: FE1 concentrations were lower (mean ±sd: 337 ±204 vs. 437 ±216 mg/g stool, p<0.05) and plasma triglycerides were higher (geometric mean */: standard deviation factor: 2.2*/:1.9 vs.1.6*/:1.8 mmol/l, p<0.05) in T2D patients vs. controls, respectively. A 10% increase in plasma triglycerides was associated with 4.5 mg/g higher FE1 concentrations in both T2D patients (p1⁄40.001) and controls (p1⁄40.005) after adjusting for confounders. In contrast, diabetes patients and controls with pathological FE1 (<100 mg/g) showed an inverse relation: low FE1 levels were associated with high plasma triglycerides, but the association was statistically significant only in controls (p1⁄40.135 for T2D and p1⁄40.012 for controls). Conclusion: Non-fasting triglycerides were positively related to FE1 in both T2D and control subjects suggesting that exocrine pancreas function influences plasma triglycerides. Marked loss of exocrine pancreatic function is associated with an opposite effect, resulting in higher levels of plasma triglycerides.