{"title":"慢性胰腺炎合并动脉高血压患者胰腺粪便弹性酶-1水平与心血管并发症的风险","authors":"A.Yu. Filippova, V.V. Kryvoshei","doi":"10.22141/2308-2097.57.3.2023.552","DOIUrl":null,"url":null,"abstract":"Background. Chronic pancreatitis and malnutrition are associated with cardiovascular diseases and cardiovascular events, while the role of exocrine pancreatic insufficiency as a risk factor for cardiovascular events is unknown. The purpose of the study was to evaluate the level of pancreatic fecal elastase-1 in patients with chronic pancreatitis combined with hypertension and to determine the relationship with cardiovascular risk. Materials and methods. One hundred and ten patients (46 men, 64 women) aged 45–65 years with chronic pancreatitis were included in the study. The first group consisted of people with a combined course of chronic pancreatitis and hypertension; the second — with chronic pancreatitis alone. The levels of total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and very low-density cholesterol, pancreatic fecal elastase-1, total protein, serum content of albumin, iron, vitamin D, zinc and magnesium were evaluated in all patients. Results. In the group 1, there were significantly more cases of severe exocrine pancreatic insufficiency and a significantly lower number of patients with a normal level of pancreatic fecal elastase-1 (p < 0.05). In addition, a very high cardiovascular risk was detected significantly more often in this group — 11.5 % (p < 0.05). The main cardiovascular risk factors among patients with chronic pancreatitis, in addition to hypertension, included obesity and increased body weight — 70.9 % of cases. Elevated levels of TG, LDL, and total cholesterol were observed in 86.4, 94.5, and 91.8 % of patients with chronic pancreatitis combined with hypertension, respectively, and a reduced content of HDL-C was found in 34.5 % (p < 0.05). Significantly higher levels of TG, LDL-C, total cholesterol, and a lower level of HDL were revealed in the group 1 compared to the group 2 (p < 0.05). In patients of the group 1, a reliable inverse correlation was found between the pancreatic fecal elastase-1 and TG, atherogenic index, the SCORE2 scale (r = –0.43, p < 0.05; r = –0.52, p < 0.05; r = –0.48, p < 0.05, respectively), as well as a reliable direct correlation with HDL level (r = 0.50; p < 0.05). Conclusions. The combined course of chronic pancreatitis with exocrine pancreatic insufficiency and hypertension is associated with an increased cardiovascular risk. A decrease in the level of pancreatic fecal elastase-1 and malnutrition may be associated with an increase in the frequency of dyslipidemia and in the risk of cardiovascular events among these patients.","PeriodicalId":31767,"journal":{"name":"Gastroenterologia","volume":"218 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The level of pancreatic fecal elastase-1 and the risk of cardiovascular complications in patients with chronic pancreatitis combined with arterial hypertension\",\"authors\":\"A.Yu. Filippova, V.V. Kryvoshei\",\"doi\":\"10.22141/2308-2097.57.3.2023.552\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background. Chronic pancreatitis and malnutrition are associated with cardiovascular diseases and cardiovascular events, while the role of exocrine pancreatic insufficiency as a risk factor for cardiovascular events is unknown. The purpose of the study was to evaluate the level of pancreatic fecal elastase-1 in patients with chronic pancreatitis combined with hypertension and to determine the relationship with cardiovascular risk. Materials and methods. One hundred and ten patients (46 men, 64 women) aged 45–65 years with chronic pancreatitis were included in the study. The first group consisted of people with a combined course of chronic pancreatitis and hypertension; the second — with chronic pancreatitis alone. The levels of total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and very low-density cholesterol, pancreatic fecal elastase-1, total protein, serum content of albumin, iron, vitamin D, zinc and magnesium were evaluated in all patients. Results. In the group 1, there were significantly more cases of severe exocrine pancreatic insufficiency and a significantly lower number of patients with a normal level of pancreatic fecal elastase-1 (p < 0.05). In addition, a very high cardiovascular risk was detected significantly more often in this group — 11.5 % (p < 0.05). The main cardiovascular risk factors among patients with chronic pancreatitis, in addition to hypertension, included obesity and increased body weight — 70.9 % of cases. Elevated levels of TG, LDL, and total cholesterol were observed in 86.4, 94.5, and 91.8 % of patients with chronic pancreatitis combined with hypertension, respectively, and a reduced content of HDL-C was found in 34.5 % (p < 0.05). Significantly higher levels of TG, LDL-C, total cholesterol, and a lower level of HDL were revealed in the group 1 compared to the group 2 (p < 0.05). In patients of the group 1, a reliable inverse correlation was found between the pancreatic fecal elastase-1 and TG, atherogenic index, the SCORE2 scale (r = –0.43, p < 0.05; r = –0.52, p < 0.05; r = –0.48, p < 0.05, respectively), as well as a reliable direct correlation with HDL level (r = 0.50; p < 0.05). Conclusions. The combined course of chronic pancreatitis with exocrine pancreatic insufficiency and hypertension is associated with an increased cardiovascular risk. A decrease in the level of pancreatic fecal elastase-1 and malnutrition may be associated with an increase in the frequency of dyslipidemia and in the risk of cardiovascular events among these patients.\",\"PeriodicalId\":31767,\"journal\":{\"name\":\"Gastroenterologia\",\"volume\":\"218 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-10-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gastroenterologia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.22141/2308-2097.57.3.2023.552\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastroenterologia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.22141/2308-2097.57.3.2023.552","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景。慢性胰腺炎和营养不良与心血管疾病和心血管事件有关,而外分泌胰腺功能不全作为心血管事件的危险因素的作用尚不清楚。本研究的目的是评估慢性胰腺炎合并高血压患者胰腺粪便弹性酶-1的水平,并确定其与心血管风险的关系。材料和方法。110例45-65岁慢性胰腺炎患者(46例男性,64例女性)纳入研究。第一组包括慢性胰腺炎和高血压合并病程的患者;第二种是单独的慢性胰腺炎。评估所有患者的总胆固醇、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、极低密度胆固醇、胰腺粪便弹性酶-1、总蛋白、血清白蛋白、铁、维生素D、锌和镁含量。结果。在组1中,严重外分泌胰腺功能不全的病例明显增多,胰腺粪便弹性酶-1正常的患者数量明显减少(p <0.05)。此外,在这一组中检测到的非常高的心血管风险明显更高——11.5% (p <0.05)。慢性胰腺炎患者的主要心血管危险因素,除了高血压,包括肥胖和体重增加- 70.9%的病例。慢性胰腺炎合并高血压患者中分别有86.4、94.5和91.8%的患者TG、LDL和总胆固醇水平升高,34.5%的患者HDL-C含量降低(p <0.05)。与2组相比,1组的TG、LDL-C、总胆固醇水平显著升高,HDL水平显著降低(p <0.05)。在1组患者中,胰腺粪便弹性酶-1与TG、动脉粥样硬化指数、SCORE2评分呈可靠的负相关(r = -0.43, p <0.05;R = -0.52, p <0.05;R = -0.48, p <,分别为0.05),并与HDL水平有可靠的直接相关(r = 0.50;p & lt;0.05)。结论。慢性胰腺炎合并外分泌胰腺功能不全和高血压的合并病程与心血管风险增加相关。胰腺粪便弹性酶-1水平的降低和营养不良可能与这些患者血脂异常频率和心血管事件风险的增加有关。
The level of pancreatic fecal elastase-1 and the risk of cardiovascular complications in patients with chronic pancreatitis combined with arterial hypertension
Background. Chronic pancreatitis and malnutrition are associated with cardiovascular diseases and cardiovascular events, while the role of exocrine pancreatic insufficiency as a risk factor for cardiovascular events is unknown. The purpose of the study was to evaluate the level of pancreatic fecal elastase-1 in patients with chronic pancreatitis combined with hypertension and to determine the relationship with cardiovascular risk. Materials and methods. One hundred and ten patients (46 men, 64 women) aged 45–65 years with chronic pancreatitis were included in the study. The first group consisted of people with a combined course of chronic pancreatitis and hypertension; the second — with chronic pancreatitis alone. The levels of total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and very low-density cholesterol, pancreatic fecal elastase-1, total protein, serum content of albumin, iron, vitamin D, zinc and magnesium were evaluated in all patients. Results. In the group 1, there were significantly more cases of severe exocrine pancreatic insufficiency and a significantly lower number of patients with a normal level of pancreatic fecal elastase-1 (p < 0.05). In addition, a very high cardiovascular risk was detected significantly more often in this group — 11.5 % (p < 0.05). The main cardiovascular risk factors among patients with chronic pancreatitis, in addition to hypertension, included obesity and increased body weight — 70.9 % of cases. Elevated levels of TG, LDL, and total cholesterol were observed in 86.4, 94.5, and 91.8 % of patients with chronic pancreatitis combined with hypertension, respectively, and a reduced content of HDL-C was found in 34.5 % (p < 0.05). Significantly higher levels of TG, LDL-C, total cholesterol, and a lower level of HDL were revealed in the group 1 compared to the group 2 (p < 0.05). In patients of the group 1, a reliable inverse correlation was found between the pancreatic fecal elastase-1 and TG, atherogenic index, the SCORE2 scale (r = –0.43, p < 0.05; r = –0.52, p < 0.05; r = –0.48, p < 0.05, respectively), as well as a reliable direct correlation with HDL level (r = 0.50; p < 0.05). Conclusions. The combined course of chronic pancreatitis with exocrine pancreatic insufficiency and hypertension is associated with an increased cardiovascular risk. A decrease in the level of pancreatic fecal elastase-1 and malnutrition may be associated with an increase in the frequency of dyslipidemia and in the risk of cardiovascular events among these patients.