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Open AccessArticle

Role of Exocrine and Endocrine Insufficiency in the Management of Patients with Chronic Pancreatitis

1
Department of Gastroenterology, San Cecilio University Hospital, 18012 Granada, Spain
2
Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
3
Department of Medical Oncology, Virgen de las Nieves University Hospital, 18014 Granada, Spain
4
Department of Biochemistry and Molecular Biology III and Immunology, University of Granada, 18071 Granada, Spain
5
Instituto de Investigación Biosanitaria (ibs.Granada), 18012 Granada, Spain
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
J. Clin. Med. 2020, 9(6), 2014; https://doi.org/10.3390/jcm9062014
Received: 18 May 2020 / Revised: 22 June 2020 / Accepted: 25 June 2020 / Published: 26 June 2020
(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)
Background: Exocrine pancreatic insufficiency results from the destruction of the pancreatic parenchyma and is diagnosed by using direct or indirect tests, both of which have shortcomings. Chronic pancreatitis is the most frequent cause of this pathology in adults. Methods: Patients meeting radiological or histological diagnostic criteria of chronic pancreatitis are enrolled and the stool elastase test is conducted, considering fecal elastase levels >200 µg/g to represent normal pancreatic function, and levels <200 μg/g to indicate the presence of exocrine pancreatic insufficiency. Additionally, we determine the body mass index of the patients and study their nutritional status and main biochemical and hematological variables, including their glucose and hemoglobin A1c (HbA1c) levels. Results: Exocrine pancreatic insufficiency is detected in 60% of the patients. Among these, 83.3% are severe cases, and 72% of the latter also are diagnosed with endocrine pancreatic insufficiency (diabetes mellitus). During the nutritional status study, HbA1c levels are significantly higher, and magnesium and prealbumin levels are significantly lower in patients with exocrine pancreatic insufficiency than in those without this disease. Conclusions: Exocrine and endocrine pancreatic insufficiency are highly prevalent among patients with chronic pancreatitis and an early diagnosis of these diseases is vital to improve the clinical management of these patients and reduce their risk of mortality. View Full-Text
Keywords: chronic pancreatitis; exocrine pancreatic insufficiency; diabetes mellitus; nutritional status; pancreatic complications chronic pancreatitis; exocrine pancreatic insufficiency; diabetes mellitus; nutritional status; pancreatic complications
MDPI and ACS Style

Diéguez-Castillo, C.; Jiménez-Luna, C.; Martín-Ruiz, J.L.; Martínez-Galán, J.; Prados, J.; Torres, C.; González-Ramírez, A.R.; Caba, O. Role of Exocrine and Endocrine Insufficiency in the Management of Patients with Chronic Pancreatitis. J. Clin. Med. 2020, 9, 2014.

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