In the article on clinical material (68 patients) showed that the presence of obesity and type 2 diabetes in chronic pancreatitis observed hyperglycemia, hyperinsulinemia and insulin resistance. The positive correlation between insulin resistance index HOMA-IR and body mass index. The definition of these indicators reveals carbohydrate metabolism in patients with chronic pancreatitis in the early stages and may indicate pancreatic origin of diabetes in these patients. The paper studied the changes of carbohydrate metabolism in patients with chronic pancreatitis (CP), combined with diabetes mellitus type 2 (DM type 2) and obese (OB). Materials and methods. In the study participated 68 patients with CP, divided groups: patients with CP - 28 people (group 1), patients with CP, combined with OB and type 2 diabetes - 40 people (group 2). The control group consisted of 15 healthy individuals. All patients who were included in the study, carried out a thorough examination using conventional clinical, laboratory and instrumental studies. To assess carbohydrate metabolism determine the level of fasting glucose, immunoreactive insulin, C-peptide, glycosylated hemoglobin index HOMA-IR. Calculated body mass index (BMI), by which determined the presence and degree of obesity. Results and discussion. In patients with CP, combined with type 2 diabetes and found OB hyperinsulinemia, hyperglycemia and increased index HOMA-IR, which confirms the presence of insulin resistance. Also found a positive correlation between body mass index and insulin resistance index HOMA-IR. The identified changes are caused by comorbid diseases - a combination of CP with diabetes type 2 and OB. Conclusions. Established that carbohydrate metabolism in patients examined manifests as insulin resistance. Identified changes increasing with increasing body weight of the patient. The definition of these indicators reveals carbohydrate metabolism in patients with chronic pancreatitis in the early stages and may indicate the origin of pancreatic diabetes in these patients.

Keywords: chronic pancreatitis, obesity, type 2 diabetes, insulin resistance, carbohydrate metabolism

Full text: PDF (Ukr) 122K

1. Vahnovskaya TV, Balahonova TV, Lukyanov MM, i dr. Osobennosti zhestkosti arterialnoy stenki arterialnyih sosudov i uroven konechnyih produktov glikirovaniya v krovi bolnyih s arterialnoy gipertoniey v sochetanii s karotidnyim arteriosklerozom. Klinicheskaya meditsina. 2013; 91 (5): 4–9.
2. Gubergrits NB, Hristich TN. Klinicheskaya pankreatologiya. Donetsk: OOO «Lebed; 2000. 416 s.
3. Gubergrits NB, Kazyulin AN. Metabolicheskaya pankreatologiya. Donetsk: Lebed; 2011. 464 s.
4. Gubergrits NB, Hristich TN, Bondarenko OA. Nealkogolnaya zhirovaya bolezn podzheludochnoy zhelezyi. Donetsk: OOO «Lebed»; 2013. 236 s.
5. Gubergrits NB. Novosti evropeyskoy i mirovoy pankreatologii. Po materialam 41-y vstrechi Evropeyskogo kluba pankreatologov. Suchasna gastroenterologiya. 2009; 4 (48): 106-10.
6. Zhuravlova LV, Shehovtsova YuO. Terapevtichni aspekti hronichnogo pankreatitu na foni tsukrovogo diabetu 2-go tipu. Therapia. Ukrainskiy medichniy visnik. 2015; 6 (99): 15-8.
7. Ivashkin VT, Shifrin OS, Sokolina IA. Hronicheskiy pankreatit i steatoz podzheludochnoy zhelezyi. M: Literatura; 2012. 200 s.
8. Titov VN, Vostrov IA, Koba SI, i dr. Lipoproteinyi nizkoy i ochen nizkoy plotnosti: patogeneticheskoe i klinicheskoe znachenie. Klinicheskaya meditsina. 2013; 1: 20-7.
9. Titov VN, Hohlov NV, Shiryaeva YuK. Glyukoza, glikotoksinyi i produktyi glikirovaniya proteinov: rol v patogeneze. Klinicheskaya meditsina. 2013; 95 (3): 15-24.
10. Unifikovaniy klinichniy protokol pervinnoyi ta vtorinnoyi (spetsializovanoyi) medichnoyi dopomogi «Tsukroviy diabet 2 tipu». Nakaz Ministerstva ohoroni zdorov'ya Ukraine vid 21.12.2012 № 1118. 56 s.
11. Unifikovaniy klinichniy protokol pervinnoyi, vtorinnoyi (spetsializovanoyi) medichnoyi dopomogi ta medichnoyi reabilitatsiyi “Hronichniy pankreatit”. Nakaz Ministerstva ohoroni zdorov`ya Ukraine vid 10.09.2014 № 638. 34 s.
12. Hristich TN, Kendzerskaya TB. Podzheludochnaya zheleza pri metabolicheskom sindrome. Eksperimentalnaya i klinicheskaya gastroenterol. 2010; 8: 83-91.
13. Hristich TN, Kendzerskaya TB, Melnichuk ZA. Rol podzheludochnoy zhelezyi neyroendokrinnoy sistemyi) v patogeneze metabolicheskogo sindroma. Suchasna gastroenterol. 2004; 1: 10-6.
14. Valnas T, Zubbers N. Serum C-reaktiv protein level is associated with abdominal aortic aneurism size and may be produced by aneurismal tissue. Circulation. 2003; 107: 1103-5. https://doi.org/10.1161/01.CIR.0000059938.95404.92