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Endocrine and exocrine pancreatic insufficiency after acute pancreatitis: long-term follow-up study.

Endocrine and exocrine pancreatic insufficiency after acute pancreatitis: long-term follow-up study.
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Tu J, Zhang J, Ke L, Yang Y, Yang Q, Lu G, Li B, Tong Z, Li W, Li J,


Tu J, Zhang J, Ke L, Yang Y, Yang Q, Lu G, Li B, Tong Z, Li W, Li J, (click to view)

Tu J, Zhang J, Ke L, Yang Y, Yang Q, Lu G, Li B, Tong Z, Li W, Li J,

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BMC gastroenterology 2017 10 2717(1) 114 doi 10.1186/s12876-017-0663-0
Abstract
BACKGROUND
Patients could develop endocrine and exocrine pancreatic insufficiency after acute pancreatitis (AP), but the morbidity, risk factors and outcome remain unclear. The aim of the present study was to evaluate the incidence of endocrine and exocrine pancreatic insufficiency after AP and the risk factors of endocrine pancreatic insufficiency through a long-term follow-up investigation.

METHODS
Follow-up assessment of the endocrine and exocrine function was conducted for the discharged patients with AP episodes. Oral Glucose Tolerance Test (OGTT) and faecal elastase-1(FE-1) test were used as primary parameters. Fasting blood-glucose (FBG), fasting insulin (FINS), glycosylated hemoglobin HBA1c, 2-h postprandial blood glucose (2hPG), Homa beta cell function index (HOMA-β), homeostasis model assessment of insulin resistance (HOMA-IR) and FE-1 were collected. Abdominal contrast-enhanced computed tomography (CECT) was performed to investigate the pancreatic morphology and the other related data during hospitalization was also collected.

RESULTS
One hundred thirteen patients were included in this study and 34 of whom (30.1%) developed diabetes mellitus (DM), 33 (29.2%) suffered impaired glucose tolerance (IGT). Moreover, 33 patients (29.2%) developed mild to moderate exocrine pancreatic insufficiency with 100μg/gCONCLUSION
The integrated morbidity of DM and IGT after AP was 59.25%, which was higher than exocrine pancreatic insufficiency. 6.2% and 29.2% of patients developed severe and mild to moderate exocrine pancreatic insufficiency, respectively. The extent of pancreatic necrosis>50%, WON and insulin resistance were the independent risk factors of new onset diabetes after AP.

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