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Abstract
Introduction. Among digestive diseases, chronic pancreatitis (HP) is noted in 5–9% of cases. In Ukraine, over the past 10 years, the prevalence of this disease has increased threefold, among adolescents — 4 times. After the diagnosis of HP and even treatment, in the next 10 years, 25% of patients become disabled with irreversible morphological changes in the gland, and known surgical interventions are only able to eliminate complications without restoring the function of the pancreas itself. Therefore, early detection and timely elimination of risk factors for this disease is extremely important. Obesity and excess body weight are among the main risk factors for the development of HP.
Aim of the study was to determine the impact of obesity on the course and clinical and laboratory blood parameters in patients with chronic pancreatitis.
Materials and methods. The study involved 182 patients (86 men and 96 women) who underwent outpatient treatment at the University Polyclinic of the Petro Mohyla Black Sea National University from January 2024 to April 2025. The patients were aged from 20 to 65 years, the average age was 42.0±1.2 years. Patients were divided into 2 groups: group 1 — 92 people (women — 40, men — 50) with chronic pancreatitis and visceral obesity of the 1st degree (BMIavg.= 32.7±1.3 kg / m²); control group — 90 people with HP without obesity (women — 45, men — 45, BMIavg.=22.4±1.4 kg/m²). Pregnant women and children under 18 years of age were not included in the study.
Research methods: general clinical examination, which included a detailed study of the anamnesis, complaints; laboratory, instrumental and statistical methods. Laboratory research included the determination of: general blood and urine analysis, biochemical blood test (determination of fasting blood glucose, GTT, HbA1c; insulin level in the blood, calculation of the HOMA-IR index); lipid profile; liver tests (AST, ALT), coprological research (determination of fecal elastase); study of the state of the pancreas (determination of alpha-amylase; lipase).
Results and discussion. In 1st group, pain syndrome was noted by 87.5% (75) patients, and in the control group — by 57.45% (52) patients (z=3.284; p=0.001). The intensity of pain syndrome in patients in group 1 was more pronounced than in the control group. In 1st group, the frequency of pronounced pain syndrome was 56.25% vs 27.66% in the comparison group (z=2.816, p=0.0048). The frequency of such a symptom as belching air was 95.83% among patients in 1st group, while in the control group — 65.96% (z=3.714, p=0.0002). Bitterness in the mouth was determined in 43.75% of patients in the observation group and in 14.89% of patients in the control group (z=3.084, p=0.002). In the control group, only 2.13% had diarrhea, while in group 1 this symptom was noted in almost 66.67% of patients (z=6.605, p=0.0001). Lipase and amylase levels in patients in group 1 were significantly higher than in the control group (61.6±7.24 vs 47.3±3.9 U/l, p=0.001; 46.3±6.73 vs 13.89±3.71 U/l, p=0.00013), respectively. The fecal elastase level in patients in group 1 was 1.4 times significantly lower (p <0.05) than in patients in the control group.
Conclusions. In patients with HP in combination with obesity, there is a more pronounced pain syndrome; an unfavorable course of the disease with early development of enzymatic and endocrine pancreatic insufficiency compared to patients in the control group. An indispensable component of the complex treatment of patients with HP and obesity, in addition to detoxification, antispasmodic and replacement enzyme therapy, should certainly be early optimization of BMI, lipid profile and modification of eating behavior.
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