ENDOTOXICOSIS AS A FACTOR OF PANCREAS FUNCTIONAL FAILURE IN THE COMBINATION OF CHRONIC PANCREATITIS AND DIABETES TYPE 2

Abstract

The progression of chronic pancreatitis (CP), especially in combination with type 2 diabetes mellitus (DM), occurs under conditions of oxidative stress and chronic inflammation due to both specific and nonspecific factors that determine the constant presence of varying degrees of endotoxicosis.The aim of the study was to investigate the status of endotoxicosis parameters in patients with chronic pancreatitis depending on the presence of a combination with type 2 diabetes mellitus, as well as their impact on the functional capacity of the pancreas.Materials and methods. 87 outpatients with CP with concomitant type 2 diabetes and without it were examined. The main group consisted of 62 patients with CP in the phase of therapeutic exacerbation in combination with diabetes mellitus in a state of sub- or full compensation, the comparison group – 25 patients with isolated CP, the control group consisted of 30 healthy individuals. The content of malonic aldehyde in the blood was determined by reaction with thiobarbituric acid, the levels of medium-molecular peptides SMP1 and SMP2 – by the method of Gabrielyan, circulating immune complexes – by precipitation in 3.75% ethylene glycol wih followed photometry.Results. The presence of active endotoxicosis and lipid peroxidation in CP was established, which was significantly more significant in the comorbidity of CP with type 2 diabetes: erythrocyte intoxication index was higher by 19.2%, the content of medium molecules MMP1 – by 29.5%, MMP2 – by 35.4%, malonic aldehyde – 10.9%, circulating immune complexes – 23.9%, ceruloplasmin – by 11.9% (p<0,05)Conclusions. A deeper level of excretory and incretory insufficiency of the pancreas in concomitant diabetes mellitus 2, which deepened with increasing endotoxicosis by the level of erythrocyte intoxication index based on an increase in the strength of significant moderate and moderate inverse correlations between it and fecal co-morbidity such in isolated CP (respectively r = -0.517 and r = -0.471, p<0.05) and significant direct moderate and medium strength correlations between levels of HbA1c and erythrocyte intoxication index – respectively r = 0.552 and r = 0.337, p<0,05.