PMID- 34231479
OWN - NLM
STAT- MEDLINE
DCOM- 20211210
LR  - 20220415
IS  - 2148-5607 (Electronic)
IS  - 1300-4948 (Print)
IS  - 1300-4948 (Linking)
VI  - 32
IP  - 5
DP  - 2021 May
TI  - Relationship between Pancreas Exocrine Insufficiency and Cardiac Autonomic 
      Neuropathy in Patients with Type 2 Diabetes Mellitus.
PG  - 481-487
LID - 10.5152/tjg.2021.19373 [doi]
AB  - BACKGROUND: The exocrine function of the pancreas is controlled by the autonomic 
      nervous system (ANS), and autonomic neuropathy is a common and serious 
      complication of diabetes. There are many factors contributing to the development 
      of autonomic neuropathy in diabetic patients. Cardiovascular tests have been 
      developed to evaluate the function of the ANS. This study investigated the 
      relationship between cardiovascular autonomic neuropathy (CAN) and pancreas 
      exocrine insufficiency (PEI) in diabetic patients. METHODS: This study evaluated 
      110 individuals with type 2 diabetes mellitus (T2DM) and 40 healthy volunteers. 
      Autonomous neuropathy tests were utilized to diagnose patients, and Ewing and 
      Clarke's criteria were employed to assess the severity of autonomous dysfunction. 
      Stool samples were also collected from patients to measure fecal elastase-1 
      (FE-1). RESULTS: A 65.5% incidence of PEI was observed in DM patients. There was 
      no significant correlation among the duration of disease, C-peptide, HbA1c, and 
      PEI, respectively (P = .782, P = .521, P = .580). However, a significant 
      difference between DM patients and controls in terms of cardiac dysautonomia (P = 
      .001) was seen. Moreover, a statistically significant correlation between the 
      degree of cardiac dysautonomia and FE-1 level was observed within the patient 
      group (P =.001). CONCLUSION: It is possible that the disruption of exocrine 
      hormone secretion in the pancreas due to the impairment of enteropancreatic 
      reflexes is secondary to diabetic autonomic neuropathy and resulting in PEI. This 
      study also showed that autonomic neuropathy might develop and cause PEI in 
      diabetic patients without known added confounding factors.
FAU - Sayiner, Zeynel Abidin
AU  - Sayiner ZA
AD  - Department of Endocrinology and Metabolism, Gaziantep University School of 
      Medicine, Gaziantep, Turkey.
FAU - Uyar, Nida
AU  - Uyar N
AD  - Department of Internal Medicine, Gaziantep University School of Medicine, 
      Gaziantep, Turkey.
FAU - Yildirim, Abdullah Emre
AU  - Yildirim AE
AD  - Department of Gastroenterology, Gaziantep University School of Medicine, 
      Gaziantep, Turkey.
LA  - eng
PT  - Journal Article
PL  - Turkey
TA  - Turk J Gastroenterol
JT  - The Turkish journal of gastroenterology : the official journal of Turkish Society 
      of Gastroenterology
JID - 9515841
RN  - EC 3.4.21.36 (Pancreatic Elastase)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Autonomic Nervous System Diseases/*complications/epidemiology
MH  - Cardiovascular Diseases/epidemiology/etiology
MH  - Case-Control Studies
MH  - Diabetes Mellitus, Type 2/*complications/epidemiology
MH  - Diabetic Neuropathies/diagnosis/epidemiology
MH  - Exocrine Pancreatic Insufficiency/*complications/epidemiology
MH  - Feces/*enzymology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pancreatic Elastase/metabolism
MH  - *Primary Dysautonomias
PMC - PMC8975291
COIS- Conflict of Interest: The authors have no conflict of interest to declare.
EDAT- 2021/07/08 06:00
MHDA- 2021/12/15 06:00
PMCR- 2021/05/01
CRDT- 2021/07/07 08:44
PHST- 2021/07/07 08:44 [entrez]
PHST- 2021/07/08 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2021/05/01 00:00 [pmc-release]
AID - tjg-32-5-481 [pii]
AID - 10.5152/tjg.2021.19373 [doi]
PST - ppublish
SO  - Turk J Gastroenterol. 2021 May;32(5):481-487. doi: 10.5152/tjg.2021.19373.