Exocrine pancreatic insufficiency related fat malabsorption and its association with autonomic neuropathy in Asian Indians with type 2 diabetes mellitus.


Journal

Diabetes & metabolic syndrome
ISSN: 1878-0334
Titre abrégé: Diabetes Metab Syndr
Pays: Netherlands
ID NLM: 101462250

Informations de publication

Date de publication:
Historique:
received: 07 06 2021
revised: 31 08 2021
accepted: 02 09 2021
pubmed: 15 9 2021
medline: 27 1 2022
entrez: 14 9 2021
Statut: ppublish

Résumé

We aimed to estimate the prevalence of exocrine pancreatic insufficiency (EPI) related fat malabsorption & to correlate it with measures of autonomic neuropathy in patients with T2DM from India. Patients with T2DM (cases; n = 118) and normo-glycaemic individuals (controls; n = 82) underwent anthropometry and biochemical evaluation at baseline. The 72-hours fecal fat excretion was estimated by the Van de Kamer's titration method. Autonomic neuropathy was evaluated using an automated analyzer. The prevalence of EPI related fat malabsorption in cases was 45% (n = 53; 72 hours mean fecal fat level = 22.7 ± 5.6 g/day). Dysfunctions in the parasympathetic nervous system (PNS; 86.7%; p < 0.05), sympathetic nervous system (SNS; 92.4%; p < 0.05), and both; PNS + SNS (83.1%; p < 0.05) were significant. Amongst measures of PNS dysfunction, there was a significantly higher percentage of abnormal expiration: inspiration ratio (45.3%) and the 30:15 ratio (84.9%) (p < 0.05) in patients with T2DM and EPI related fat malabsorption. In this cross-sectional cohort of Asian Indian patients with T2DM (n = 118), EPI related fat malabsorption correlates significantly with autonomic dysfunction in patients with T2DM. However, these preliminary data need to confirmed in trials with more robust design.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
We aimed to estimate the prevalence of exocrine pancreatic insufficiency (EPI) related fat malabsorption & to correlate it with measures of autonomic neuropathy in patients with T2DM from India.
METHODS METHODS
Patients with T2DM (cases; n = 118) and normo-glycaemic individuals (controls; n = 82) underwent anthropometry and biochemical evaluation at baseline. The 72-hours fecal fat excretion was estimated by the Van de Kamer's titration method. Autonomic neuropathy was evaluated using an automated analyzer.
RESULTS RESULTS
The prevalence of EPI related fat malabsorption in cases was 45% (n = 53; 72 hours mean fecal fat level = 22.7 ± 5.6 g/day). Dysfunctions in the parasympathetic nervous system (PNS; 86.7%; p < 0.05), sympathetic nervous system (SNS; 92.4%; p < 0.05), and both; PNS + SNS (83.1%; p < 0.05) were significant. Amongst measures of PNS dysfunction, there was a significantly higher percentage of abnormal expiration: inspiration ratio (45.3%) and the 30:15 ratio (84.9%) (p < 0.05) in patients with T2DM and EPI related fat malabsorption.
CONCLUSION CONCLUSIONS
In this cross-sectional cohort of Asian Indian patients with T2DM (n = 118), EPI related fat malabsorption correlates significantly with autonomic dysfunction in patients with T2DM. However, these preliminary data need to confirmed in trials with more robust design.

Identifiants

pubmed: 34520998
pii: S1871-4021(21)00293-9
doi: 10.1016/j.dsx.2021.102273
pii:
doi:

Substances chimiques

Biomarkers 0
Blood Glucose 0
Dietary Fats 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102273

Informations de copyright

Copyright © 2021 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no conflicts of interest pertaining to this study.

Auteurs

Shajith Anoop (S)

Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India.

Riddhi Dasgupta (R)

Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India.

Felix K Jebasingh (FK)

Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India.

Roshna Ramachandran (R)

Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India.

Mathews Edatharayil Kurian (ME)

Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India.

Grace Rebekah (G)

Department of Biostatistics, Christian Medical College, Vellore, India.

K A Balsubramanian (KA)

Division of Gastrointestinal Sciences, Wellcome Research Laboratory, Christian Medical College, Vellore, India.

Nihal Thomas (N)

Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India. Electronic address: nihal_thomas@cmcvellore.ac.in.

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Classifications MeSH