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Received: September 17th, 2020 - Accepted: November 6th, 2020
Abstract
Studying the significance of the immune response to damage and adipokine levels is urgent regarding the development of both chronic pancreatitis and type 2 diabetes mellitus. Our objective was to study the indices of tumor necrosis factor-а (TNF-a), C-reactive protein (CRP), adiponectin, leptin, and resistin as links for triggering the mechanisms of development and progression of the low-grade chronic systemic inflammatory response in chronic pancreatitis (CP) patients with type 2 diabetes mellitus (T2DM). The study groups consisted of 87 patients: 47 patients with isolated CP (group I), 40 with CP combined with T2DM (group II), and 41 practically healthy persons. It has been established that in patients with isolated CP, the TNF-а concentration showed a reliable 1.57-fold (p <0.05) increase compared to practically healthy persons (PHP) and a 1.32-fold increase in patients who also had T2DM (p<0.05). CP patients with type 2 diabetes mellitus had the highest CRP indices (5.5-fold, p <0.05. TNF-а and C-reactive protein indices were higher in patients with chronic pancreatitis and T2DM than those with isolated chronic pancreatitis, characterizing the persistence of chronic systemic inflammation in case of the combined clinical course of these diseases.
Keywords: Chronic pancreatitis, type 2 diabetes mellitus, tumor necrosis factor, C-reactive protein, adiponectin, leptin, resistin.
Abbreviations: CRP - C-reactive protein; CP - cronic pancreatitis; PHP - practically healthy persons; TNF-а - Tumor necrotic factor - а.
Introduction
Low-grade chronic systemic inflammation determines the possibility of chronic pancreatitis (CP) and type 2 diabetes mellitus (T2DM) coexistence. It depends on the intensity of the immune response to damage. During the implementation, significance is given to pro-inflammatory cytokines and CRP [1, 2]. According to some authors, C-reactive protein (CRP), as a protein of acute phase of inflammation, is a more informative marker of chronic systemic inflammation in the body [3] since it supports the inflammatory series in patients with CP, obesity, and diabetes mellitus [4].
A reliable increase of TNF-а in the blood was determined not only in the blood of patients with recurrent CP and during the period of exacerbation but also in the remission phase, which testifies to the prolongation of the chronic low-inflammatory process in the pancreas (PG) in the inter-recurrent period [5]. However, TNF-а...