Consideration and analysis of exocrine pancreatic insufficiency in assotiative pathology of the digestive tract, unresolved issues

Aim: To identify and analyze the patterns of exocrine insufficiency development in patients with assotiative pathology of the digestive tract and its relationship with homeostasis disorders depending on the degree of insufficiency.

Materials and Methods: The total number of patients is 135, aged 50.7±6.2 years, with a diagnosis of Chronic pancreatitis (CP), remission phase with exocrine insufficiency in assotiation with Metabolic-associated steatotic liver disease (MASLD) and gastroesophageal reflux disease (GERD). The divided of patients into groups was based on determining the degree of exocrine pancreatic insufficiency according to the results of the level of fecal elastase-1(FE-1).

Results: In the studied children of the first group, significant differences (p1=0.01-<0.001) were observed in the levels of biochemical indicators, except the values of AST and creatinine levels. Significant intergroup differences were found among the indicators of vitamin D3 (p1<0.001; p2=0.001; p3<0.001), folic acid (p1<0.001; p2<0.001; p3<0.001), Zn (p1=0.001; p2=0.001; p3<0.001), Se (p1<0.001; p2<0.001; p3<0.001) and partly, Na (p1=0.02;) Ca (p2=0.002; p3=0.001), Cl(p3=0.04).

Conclusions: The highest communicative correlations in children of the first group were found for the vitamin D3 level with FE-1 (r=0.64) and fibrinogen in a negative direction (r=-0.30). The value of 1-antitrypsin was correlated in the first group with the minerals Ca (-0.30 at p=0.006), FE-1 (r=-0.26 at p=0.02), while in the second group there was a predominance of communications with inflammatory markers ALT (r=-0.30 at p=0.03), AST (r=-0.29 at p=0.04).