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- Title
The role of endogenous insulin in patients with acute pancreatitis.
- Authors
Dronov, O. I.; Kovalska, I. O.; Ivanets, T. Yu.; Kozachuk, Ye. S.; Levchenko, L. V.; Stasiuk, U. V.
- Abstract
Background. Acute pancreatitis is an inflammatory disease of the exocrine part of the pancreas, accompanied by various complications and further development of necrosis of the gland and parapancreatic tissue with possible secondary infection. The study of experimental models shows that the acinar cells surrounding the islets of Langerhans remain relatively intact, indicating that endogenous insulin is a protective factor for the pancreatic parenchyma. The purpose of the study was to determine the dependence of endogenous insulin levels on the extent of pancreatic parenchymal damage. Materials and methods. Prospective analysis of endogenous insulin levels in 51 patients with acute pancreatitis. Results. Comparison of the mean values of endogenous insulin revealed that in patients with necrotizing pancreatitis, the median value was statistically significantly lower than in patients without pancreatic necrosis (p < 0.001). Moreover, in pancreatic necrosis, the determined level of endogenous insulin did not exceed 9 mcIU/ml and in 7 (13.7 %) patients, insulin was below the reference values. ROC analysis showed that low endogenous insulin is a risk factor for pancreatic necrosis. The threshold value of endogenous insulin, at which pancreatic necrosis was most often diagnosed, was determined, cut-off value of 5.3 mcIU/ml, AUC of 0.96 (95% CI 0.92–1.00) (sensitivity 91.89 % (95% CI 78.09–98.3 %), specificity 71.43 % (95% CI 41.9–91.61 %), PPV 89.47 % (95% CI 78.69–95.14 %), NPV 76.92 % (95% CI 51.74–91.2 %)). Conclusions. There was a statistically significant difference between the mean insulin values depending on the volume and location of pancreatic parenchymal damage (p < 0.001). In patients without pancreatic necrosis, endogenous insulin was statistically significantly higher than in those with pancreatic necrosis (p < 0.001). Binomial logistic regression analysis showed that the development of pancreatic necrosis in patients with acute pancreatitis significantly depended on the values of endogenous insulin at hospitalization. The level of endogenous insulin may be an additional indicator of the acute pancreatitis severity and the formation of necrotic changes in the pancreatic tissue, which will allow for correct initiation of treatment.
- Subjects
NECROTIZING pancreatitis; REFERENCE values; LOGISTIC regression analysis; ISLANDS of Langerhans; INSULIN
- Publication
International Journal of Endocrinology / Mìžnarodnij Endokrinologìčnij Žurnal, 2024, Vol 20, Issue 8, p607
- ISSN
2224-0721
- Publication type
Academic Journal
- DOI
10.22141/2224-0721.20.8.2024.1468