Актуальные патогенетические аспекты коморбидности хронического панкреатита и сахарного диабета 2-го типа

Most diseases of the pancreas (P) are considered as conditions that affect both the excretory and endocrine regions of the organ, which leads to the development of chronic pancreatitis (CP) and type 2 diabetes mellitus (DM-2) that are often combined. Purp ose. To assess the state of typical pathogenetic syndromes (inflammation, endotoxicosis, liperoxidation, enzymatic and non-enzymatic antioxidant deficiency) in comorbidity of chronic pancreatitis and type 2 diabetes mellitus. Ma t erials and methods. We examined 137 patients (112 patients with comorbidity of CP and DM-2 and 25 patients with isolated CP). Certain parameters of endotoxicosis, proand antioxidant status, and liperoxidation were studied. Results . There  were  stated  statistically  significant  more important  pathogenic  changes in endotoxicosis, proand antioxidant status, and liperoxidation in comorbidity of CP and DM-2 if compared with those in isolated CP. It was proved that patients with CP, even in the remission phase, had an active course of EI and LPO, which was significantly more important in comorbidity with DM-2. Discussion. Statistically significant more important changes of the AOD parameters were found in the comorbidity of CP and T2DM in comparison with isolated CP. They proved a significant decrease of vitamin non-enzymatic antioxidants in the blood in patients with CP in relation to the control group and deepening of this decrease in patients with comorbidity of CP and DM-2 in relation to those in patients with isolated CP. This proved not only the decrease of the ability of AOD on nonenzymatic antioxidants-vitamins, but also deepening of trophological  vitamin  deficiency  in  the joint course of CP and DM-2 if compared with the isolated course of CP. Conclusion. Depletion of the complement system in the groups of patients with CP and CP plus DM-2 was revealed, which proved the complicating role of DM-2 on the protective potential of the complement system and confirmed the assumption of a more significant depletion of the visceral protein pool in CP in comorbidity with DM-2. Treatment of CP and type 2 DM is a difficult task and should take into account the effect on the investigated common typical pathogenetic syndromes – inflammation, endotoxicosis, lipid peroxidation, and deficiency of enzymatic and non-enzymatic antioxidant protection – to solve short-term complications and prevent long-term ones.