Peculiarities of treatment of patients with comorbid pathology: chronic pancreatitis and hypothyroidism, taking into account SEPP1 gene polymorphism (RS7579)

Abstract

Optimization of therapeutic regimens during the treatment of the polymorbid course of chronic pancreatitis combined with hypothyroidism is an important task of modern science.
 Aim: to treat patients with comorbid pathology: chronic pancreatitis and hypothyroidism, taking into account the polymorphism of the SEPP1 gene (RS7579)
 Materials and methods. During the research, we examined 128 people. Patients were divided into 3 groups. The first group included 48 patients with chronic pancreatitis, the second - 50 patients with chronic pancreatitis in combination with hypothyroidism, and the third - 30 practically healthy people.
 Results. Symptoms of maldigestion decreased in 72 % of the examined patients. Signs of nutritional deficiency have significantly decreased, and general well-being has improved. Multicomponent therapy also affected mood, sleep, and reduced irritability and symptoms of depression and anxiety disorders. A multisystemic polysyndromic approach to treatment led to improvements in both pancreatic and thyroid function. The effectiveness of the treatment strategy for patients with chronic pancreatitis was dependent on individual characteristics, such as the severity of chronic pancreatitis, the presence of primary hypothyroidism, the degree of selenium deficiency and concomitant symptoms, taking into account polymorphic variants of the SEPP1 (rs7579) gene. Selenoid deficiency decreased, especially in the group with a combination of chronic pancreatitis and hypothyroidism. The improvement in thyroid hormone activity included a 40.46 % decrease in blood TSH and a 2.5-fold increase in free T4.
 Conclusions. The program of complex therapy led to the normalization of the condition of patients with the G-allele genotype of the SEPP1 gene (rs7579), as evidenced by significant improvements in most of the analyzed indicators. The concentration of fecal elastase 1 and blood selenoprotein P significantly increased, and the level of serum pancreatic α-amylase significantly decreased in carriers of the AA genotype. Under the influence of therapy, there were also changes in the hormonal activity of the thyroid gland, a decrease in the concentration of total metabolites of NO, and an improvement in the health indicators of the cardiovascular system. However, for patients with the AA genotype of the SEPP1 (rs7579) gene, continuation of therapy remains important to achieve an optimal condition, in particular, to manage cholesterol levels and other cardiovascular risk factors