Exocrine pancreatic insufficiency related fat malabsorption and its association with autonomic neuropathy in Asian Indians with type 2 diabetes mellitus. Issue 5 (September 2021)

• Record Type: Journal Article
• Authors: Anoop, Shajith; Dasgupta, Riddhi; Jebasingh, Felix K.; Ramachandran, Roshna; Kurian, Mathews Edatharayil; Rebekah, Grace; Balsubramanian, K.A; Thomas, Nihal
• Is Part Of: Diabetes & metabolic syndrome. Volume 15:Issue 5(2021)
• Publication Date: 2021-09
• Subjects: Exocrine pancreatic insufficiency -- Fat malabsorption -- Type 2 diabetes mellitus -- 72 h fecal Fat assay -- Autonomic dysfunction -- Asian indians; Diabetes -- Periodicals; Metabolism -- Disorders -- Periodicals; Diabetes Mellitus -- Periodicals; Metabolic Diseases -- Periodicals; Diabète -- Périodiques; Métabolisme, Troubles du -- Périodiques; Endocrinologie -- Périodiques; Diabète -- Physiopathologie -- Périodiques; Diabetes; Metabolism -- Disorders; Electronic journals; Periodicals; 616.462
• DOI: 10.1016/j.dsx.2021.102273
• Languages: English
• ISSNs: 1871-4021

Abstract

Abstract: Background and aims: We aimed to estimate the prevalence of exocrine pancreatic insufficiency (EPI) related fat malabsorption & to correlate it with measures of autonomic neuropathy in patients with T2DM from India. Methods: Patients with T2DM (cases; n = 118) and normo-glycaemic individuals (controls; n = 82) underwent anthropometry and biochemical evaluation at baseline. The 72-hours fecal fat excretion was estimated by the Van de Kamer's titration method. Autonomic neuropathy was evaluated using an automated analyzer. Results: The prevalence of EPI related fat malabsorption in cases was 45% (n = 53; 72 hours mean fecal fat level = 22.7 ± 5.6 g/day). Dysfunctions in the parasympathetic nervous system (PNS; 86.7%; p < 0.05), sympathetic nervous system (SNS; 92.4%; p < 0.05), and both; PNS + SNS (83.1%; p < 0.05) were significant. Amongst measures of PNS dysfunction, there was a significantly higher percentage of abnormal expiration: inspiration ratio (45.3%) and the 30:15 ratio (84.9%) (p < 0.05) in patients with T2DM and EPI related fat malabsorption. Conclusion: In this cross-sectional cohort of Asian Indian patients with T2DM (n = 118), EPI related fat malabsorption correlates significantly with autonomic dysfunction in patients with T2DM. However, these preliminary data need to confirmed in trials with more robust design. Highlights: EPI related fat malabsorption in patients with T2DM were assayed by the 72 h fecal fat assay. The prevalence of EPI related fat malabsorption in patients with T2DM was 45% Parasympathetic nervous system dysfunctions were highly prevalent (86.7%) in patients with T2DM and fat malabsorption.