The spectrum of pancreatic exocrine and endocrine (beta-cell) function in tropical calcific pancreatitis

Exocrine pancreatic marker (immunoreactive-trypsin) and endocrine Beta-cell function (plasma insulin and C-peptide during an oral glucose tolerance test) were studied in 40 subjects with tropical-calcific-pancreatitis [seven non-diabetic, seven with impaired-glucose-tolerance and 26 diabetic (fibro-...

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Bibliographic Details
Published in:Diabetologia 1990-07, Vol.33 (7), p.417-421
Main Authors: YAJNIK, C. S, SHELGIKAR, K. M, SAHASRABUDHE, R. A, NAIK, S. S, PAI, V. R, ALBERTI, K. G. M. M, HOCKADAY, T. D. R, KATRAK, A, DANDONA, P
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Blood Glucose - metabolism
C-Peptide - blood
C-Peptide - metabolism
Child
Chronic Disease
Diabetes Mellitus - blood
Diabetes Mellitus - physiopathology
Diabetes. Impaired glucose tolerance
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Female
Glucose Tolerance Test
Humans
India
Insulin - blood
Insulin - metabolism
Insulin Secretion
Islets of Langerhans - metabolism
Male
Medical sciences
Pancreas - enzymology
Pancreatitis - blood
Pancreatitis - physiopathology
Reference Values
Tropical Climate
Trypsin - blood
Trypsin - metabolism
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Summary:Exocrine pancreatic marker (immunoreactive-trypsin) and endocrine Beta-cell function (plasma insulin and C-peptide during an oral glucose tolerance test) were studied in 40 subjects with tropical-calcific-pancreatitis [seven non-diabetic, seven with impaired-glucose-tolerance and 26 diabetic (fibro-calculous-pancreatic-diabetes)]. In non-diabetic and impaired-glucose-tolerance subjects there was evidence of active pancreatitis in some and exocrine function was partially preserved. Fibro-calculous-pancreatic-diabetic subjects showed severely diminished exocrine pancreatic function; none showed 'pancreatitic' elevation of immunoreactive-trypsin. Beta-cell function was preserved in non-diabetic and impaired-glucose-tolerance subjects; diabetic subjects showed variable Beta-cell function but it was severely diminished in more than 75%. Immunoreactive-trypsin and C-peptide were directly correlated (rs = 0.55, p less than 0.01). This cross sectional study demonstrates, for the first time, that the Beta-cell loss in tropical-calcific-pancreatitis is related to the exocrine loss. It suggests that diabetes in tropical-calcific-pancreatitis is either secondary to pancreatitis or that a common factor(s) acts simultaneously on both components.
ISSN:0012-186X
1432-0428
DOI:10.1007/BF00404091