Российский журнал гастроэнтерологии, гепатологии, колопроктологии (May 2013)
Metabolic syndrome and pancreatic lesions
Abstract
Aim of investigation. To study features of pancreatic involvement in patients with metabolic syndromeMaterial and methods. Overall 720 patients were investigated who have admitted to the clinic with referral diagnosis «chronic pancreatitis» (CP). Of them steatosis of pancreas (SP) was diagnosed in 49 and in 290 – chronic pancreatitis. Original investigation algorithm was based on tasks of the study and included careful inquiry and physical investigation of patients. Laboratory and instrumental studies included: total and biochemical blood tests, lipid profile, coprological test, transabdominal and (under specific indications) endoscopic abdominal US, esophagogastroduodenoscopy (EGDS), computer tomography (CT) of abdominal organs, magnetic-resonance investigation (MRI).Results. According to diagnostic criteria of metabolic syndrome, the latter was detected in 48 patients. Abdominal CT was considered as non-invasive method of investigation allowing to reliably diagnose SP. At CT in 49 cases SP was revealed. Direct CT signs of SP include decrease in pancreatic density score (<30 HU), lobulated pattern of the gland with pronounced fatty layers. Diagnosis of chronic pancreatitis was made according to conventional clinical, laboratory and radiological criteria. The metabolic syndrome was significantly more frequent (р<0,05) in patients with SP, than at chronic inflammatory pancreatitis: in 29 of 49 cases (59,2%) and in 29 of 147 cases (19,7%) respectively. The issue of application of new phospholipid drug Resalut in patients with SP, associated to hepatic steatosis and lipidemia is discussed. Conclusion. Steatosis of the pancreas can be considered as diffuse development of fatty tissue in all parts of the organ, developing mainly on the background of metabolic syndrome and combined to smoldering pancreatic inflammation under influence of pancreatoxic factors – alcohol, gallstone disease. Efficacy of new phospholipid drug Resalut in patients with steatosis of the pancreas associated to hepatic steatosis and lipidemia is demonstrated.
