nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-209-1-60-65GSQTZInogr-2263Research ArticleКЛИНИЧЕСКАЯ ГАСТРОЭНТЕРОЛОГИЯCLINICAL GASTROENTEROLOGYЭкзокринная дисфункция поджелудочной железы у детей с сахарным диабетом 1 типаPancreatic exocrine disfunction in children with type 1 diabetes mellitushttps://orcid.org/0000-0001-9257-0171ГореловА. В.GorelovA. V.

Горелов Александр Васильевич, член-корреспондент РАН, доктор медицинских наук, профессор, заместитель директора по научной работе 

ул. Новогиреевская, 3А, 111123, Москва, Россия

Aleksandr V. Gorelov, MD, PhD, DSc, Academy of Sciences, Professor, Deputy Director for Research, Central Research Institute of Epidemiology

Scopus Author ID: 7005253154 

 3A Novogireyevskaya Str, Moscow, 111123, Russia 

https://orcid.org/0000-0002-7408-5719НижевичА. А.NijevitchA. A.

Нижевич Александр Альбертович, д. м. н., профессор кафедры госпитальной педиатрии 

ул. Степана Кувыкина 98, г. Уфа, Республика Башкортостан, 450106, Россия 

Alexander A. Nijevitch, MD, Assistant of the Professor Department of hospital pediatrics

Scopus Author ID: 6701670789 

 98 str. St. Kouvykina, Ufa, 450106, Russia 

aanj@yandex.ruhttps://orcid.org/0000-0003-2599-0867МалиевскийО. А.MalievskiyO. A.

 

ул. Степана Кувыкина 98, г. Уфа, Республика Башкортостан, 450106, Россия 

Oleg A. Malievskiy, MD, PhD, Professor of Department of hospital pediatrics

Scopus Author ID: 25422188400 

98 str. St. Kouvykina, Ufa, 450106, Russia 

ЯкуповаГ. М.YakupovaG. M.

 

ул. Степана Кувыкина 98, г. Уфа, Республика Башкортостан, 450106, Россия 

 G. M. Yakupova 

 98 str. St. Kouvykina, Ufa, 450106, Russia 

https://orcid.org/0000-0003-0522-7442МалиевскийВ. А.MalievskiyV. A.

Малиевский Виктор Артурович, д. м. н., профессор, заведующий кафедрой госпитальной педиатрии 

 ул. Степана Кувыкина 98, г. Уфа, Республика Башкортостан, 450106, Россия 

Victor A. Malievskiy, MD, PhD, Professor, Head of the hospital pediatrics department

Scopus Author ID: 57221314432 

98 str. St. Kouvykina, Ufa, 450106, Russia 

https://orcid.org/0000-0002-0229-0238АрслановА. А.ArslanovA. A.

Арсланов Артур Альбертович, обучающийся 6 курса педиатрического факультета 

 3, г. Уфа, Республика Башкортостан, 4500057, Россия

 

Artur A. Arslanov, sixth-year student of the Faculty of Pediatrics

Scopus Author ID: 57559507700 

3 str. Lenina, Ufa, 450000, Russia 

Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человекаРоссияFederal Service on Customers' Rights Protection and Human Well-being SurveillanceRussian FederationГБУЗ «Республиканская детская клиническая больница»РоссияChildren’s Republican HospitalRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Башкирский государственный медицинский университет» Министерства здравоохранения Российской Федерации, ул. ЛенинаРоссияBashkir State Medical UniversityRussian Federation202321052023116065Copyright © Горелов А.В., Нижевич А.А., Малиевский О.А., Якупова Г.М., Малиевский В.А., Арсланов А.А., 20232023Горелов А.В., Нижевич А.А., Малиевский О.А., Якупова Г.М., Малиевский В.А., Арсланов А.А.Gorelov A.V., Nijevitch A.A., Malievskiy O.A., Yakupova G.M., Malievskiy V.A., Arslanov A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/2263

Целью настоящего исследования явилась оценка экзокринной функции поджелудочной железы у детей с сахарным диабетом (СД) 1 типа в динамике течения заболевания.Уровень фекальной эластазы варьировал от 24,4 до 169,6 мкг/г (медиана 134,5 мкг/г) у детей с СД 1 типа и сопутствующей экзокринной недостаточностью (ЭН). Количество детей с диареей достоверно не различалось между детьми с низким уровнем панкреатической эластазы и детьми с нормальным уровнем (43,0% против 35,5%, р=0,359). У остальных детей с СД 1 типа уровень фекальной эластазы-1 находился в пределах от 201,4 до 810,5 мкг/г стула (медиана 650,7 мкг/г). Различия между больными СД 1 типа без ЭН и группой сравнения были недостоверны (р=0,112).Медиана суточной фекальной экскреции жира у больных СД 1 типа с ЭН составила 8,31 г/сут (min-mах 7,81–9,21 г/сут), что достоверно выше, чем у детей с СД 1 типа без ЭН (3,87 г/сут; min-mах 2,97–6,33 г/сут; р= 0,0003). Достоверной разницы в суточной экскреции жира с калом между детьми с СД 1 типа без признаков ЭН и детьми контрольной группы не было (2,91 г/сут; min-max: 2,31–5,74 г/сут; р=0,091).Результаты настоящего исследования демонстрируют ЭН у детей с длительно текущим СД 1-го типа.Концентрация эластазы-1 в кале достоверно коррелирует с уровнем экзокринной эластазы двенадцатиперстной кишки. Уровень фекальной эластазы-1 имеет сильную корреляцию с экскрецией жира с калом, который измеряли с помощью кислотного стеатокритного теста.

The aim of the present study was to evaluate exocrine pancreatic function in children with type 1 diabetes mellitus during the course of the disease.Fecal elastase varied between 24.4 and 169.6 μg /g (median 134.5 μg /g) in children with type 1 DM and concomitant PEI. Number of children with diarrhea was not significantly different between children with low pancreatic elastase levels and those with normal levels (43.0% versus 35.5%, p=0.359). The remainder of the children with type 1 DM had fecal elastase-1 levels between 201.4 and 810.5 μg /g stool (median 650.7 μg /g). Differences between the type 1 DM patients without PEI and the comparison group were not significant (p=0.112).Median daily fecal fat excretion in type 1 DM patients with PEI was 8.31 g/day (min-mах 7.81–9.21 g/day), which was significantly higher than in type 1 DM children without PEI (3.87 g/day; min-mах 2.97–6.33 g/day; р= 0.0003). There was no significant difference in daily fecal fat excretion between children with type 1 DM without signs of PEI and children in the control group (2.91 g/d; min-max: 2.31–5.74 g/d; р= 0.091).The results of this study demonstrate PEI in children with long-standing type 1 DM.Fecal elastase-1 concentration significantly correlates with duodenal exocrine elastase output. Fecal elastase-1 levels have a good correlation with fecal fat excretion, which was measured by employing the acid steatocrit test.

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The authors declare that there are no conflicts of interest present.