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Exocrine pancreatic function in children and adolescents with insulin-dependent diabetes mellitus
R Lorini1, L Cortona, M S Scotta
1Department of Pediatrics, I.R.C.C.S., University of Pavia, Italy.
Insights
Diabetic children show impaired exocrine pancreatic function, with significantly lower levels of trypsin and elastase. This suggests potential pancreatic enzyme deficiencies in pediatric diabetes.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Metabolic Disorders
Background:
- Type 1 diabetes mellitus (T1DM) can affect multiple organ systems.
- The exocrine pancreas plays a crucial role in digestion.
- Subtle exocrine pancreatic dysfunction may occur in children with T1DM.
Purpose of the Study:
- To evaluate exocrine pancreatic function in children with T1DM.
- To compare pancreatic enzyme levels in diabetic children versus healthy controls.
- To investigate correlations between pancreatic function and disease parameters.
Main Methods:
- Assessed exocrine pancreatic function in 21 diabetic children and controls.
- Utilized the p-aminobenzoic acid (PABA) test.
- Measured serum levels of amylase, pancreatic isoamylase, lipase, trypsin, and elastase.
- Quantified fecal chymotrypsin levels.
Main Results:
- Diabetic children exhibited significantly lower serum trypsin (P < 0.001) and elastase (P < 0.02) levels compared to controls.
- Fecal chymotrypsin was lower in diabetic children (P < 0.01), but remained within normal limits.
- No significant correlations were found between enzyme levels and age, HbA1, or insulin requirements.
- Serum PABA showed a negative correlation with disease duration (P < 0.01).
Conclusions:
- Exocrine pancreatic function may be abnormal in children with T1DM.
- Specific pancreatic enzymes like trypsin and elastase appear to be reduced.
- Further research is warranted to understand the clinical implications of these findings.
Abstract:
Exocrine pancreatic function was evaluated in 21 diabetic children on the basis of a p-aminobenzoic acid (PABA) test and a determination of fasting serum amylase, pancreatic isoamylase, lipase, trypsin and elastase levels. Fecal chymotrypsin was also measured. Compared to the controls, the diabetic children had significantly lower levels of trypsin (P less than 0.001) and elastase (P less than 0.02). Fecal chymotrypsin appeared to be significantly lower (P less than 0.01) in diabetic children than in controls but in all patients fecal chymotrypsin values registered above the limit considered to be normal. No significant correlation was observed between pancreatic enzyme concentrations, serum and urinary PABA values, and chronologic age, HbA1 and insulin requirement. Only for serum PABA a significant negative correlation with duration of disease (P less than 0.01) has been observed. These data show that exocrine pancreatic function may be abnormal in children with IDDM.