The role of endogenous insulin in patients with acute pancreatitis
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 ce...
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Zaslavsky O.Yu.
2024-12-01
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| Series: | Mìžnarodnij Endokrinologìčnij Žurnal |
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| Online Access: | https://iej.zaslavsky.com.ua/index.php/journal/article/view/1468 |
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| author | O.I. Dronov I.O. Kovalska T.Yu. Ivanets Ye.S. Kozachuk L.V. Levchenko U.V. Stasiuk |
| author_facet | O.I. Dronov I.O. Kovalska T.Yu. Ivanets Ye.S. Kozachuk L.V. Levchenko U.V. Stasiuk |
| author_sort | O.I. Dronov |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-bab49b79dea24d1aa69eba1540eaab6d |
| institution | Kabale University |
| issn | 2224-0721 2307-1427 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Zaslavsky O.Yu. |
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| series | Mìžnarodnij Endokrinologìčnij Žurnal |
| spelling | doaj-art-bab49b79dea24d1aa69eba1540eaab6d2025-01-12T12:20:34ZengZaslavsky O.Yu.Mìžnarodnij Endokrinologìčnij Žurnal2224-07212307-14272024-12-0120860761210.22141/2224-0721.20.8.2024.14681466The role of endogenous insulin in patients with acute pancreatitisO.I. Dronov0https://orcid.org/0000-0003-4033-3195I.O. Kovalska1https://orcid.org/0000-0002-6264-2928T.Yu. Ivanets2https://orcid.org/0000-0003-1564-7168Ye.S. Kozachuk3https://orcid.org/0000-0002-2453-2496L.V. Levchenko4https://orcid.org/0000-0003-1356-6647U.V. Stasiuk5https://orcid.org/0009-0004-9752-208XBogomolets National Medical University, Kyiv, UkraineBogomolets National Medical University, Kyiv, UkraineBogomolets National Medical University, Kyiv, UkraineUkrainian Scientific and Practical Centre of Endocrine Surgery, Transplantation of Endocrine Organs and Tissues, Kyiv, UkraineBogomolets National Medical University, Kyiv, UkraineBogomolets National Medical University, Kyiv, UkraineBackground. 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.https://iej.zaslavsky.com.ua/index.php/journal/article/view/1468acute pancreatitisnecrosisendogenous insulinseverity |
| spellingShingle | O.I. Dronov I.O. Kovalska T.Yu. Ivanets Ye.S. Kozachuk L.V. Levchenko U.V. Stasiuk The role of endogenous insulin in patients with acute pancreatitis Mìžnarodnij Endokrinologìčnij Žurnal acute pancreatitis necrosis endogenous insulin severity |
| title | The role of endogenous insulin in patients with acute pancreatitis |
| title_full | The role of endogenous insulin in patients with acute pancreatitis |
| title_fullStr | The role of endogenous insulin in patients with acute pancreatitis |
| title_full_unstemmed | The role of endogenous insulin in patients with acute pancreatitis |
| title_short | The role of endogenous insulin in patients with acute pancreatitis |
| title_sort | role of endogenous insulin in patients with acute pancreatitis |
| topic | acute pancreatitis necrosis endogenous insulin severity |
| url | https://iej.zaslavsky.com.ua/index.php/journal/article/view/1468 |
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