leptin and Pancreatitis--Chronic

This review focuses on seven aspects of physiology and pathophysiology of the exocrine pancreas that have been intensively discussed and studied within the past few years: (1) the role of neurohormonal mechanisms like melatonin, leptin, or ghrelin in the stimulation of pancreatic enzyme secretion; (2) the initiation processes of acute pancreatitis, like fusion of zymogen granules with lysosomes leading to intracellular activation of trypsinogen by the lysosomal enzyme cathepsin B, or autoactivation of trypsinogen; (3) the role of genes in the pathogenesis of acute pancreatitis; (4) the role of alcohol and constituents of alcoholic beverages in the pathogenesis of acute pancreatitis; (5) the role of pancreatic hypertension, neuropathy, and central mechanisms for the pathogenesis of pain in chronic pancreatitis; (6) the relation between exocrine pancreatic function and diabetes mellitus; and (7) pathophysiology, diagnosis and treatment of pancreatic steatorrhea.

Topics: Cathepsin B; Diabetes Mellitus; DNA Mutational Analysis; Ghrelin; Leptin; Melatonin; Pancreas; Pancreatic Juice; Pancreatitis, Acute Necrotizing; Pancreatitis, Alcoholic; Pancreatitis, Chronic; Trypsinogen

Pancreatic cancer and chronic pancreatitis are still significant diagnostic and clinical problems. The clinical impact of preoperative serum carbohydrate antygen 19-9 (CA 19-9) levels have been disscussed. The aim of this study was a comparative analysis of the concentrations in serum of adipocytokines: adiponectin and leptin and CA 19-9 in patients with pancreatic cancer (PC), chronic pancreatitis (CP) and control group (CG). The study was performed in a group of 90 patients. Group 1 consisted of 30 patients with PC, group 2 consisted of 30 patients with CP. There was no coincidence of pancreatic cancer in CP group. Group 3 (CG) consisted of 30 persons and were recruited among patients operated for cholelithiasis. The serum samples were taken from patients and the concentration of adiponectin, leptin, CA 19-9 and CEA were evaluated. The revealed concentrations levels of the adiponectin were significantly higher in the PC serum samples compared to the CP and CG. There was no significant correlation between increased adiponectin concentration and body fat mass in the PC group. The concentration of leptin was significantly lower in CP serum samples compared to PC and CG. The concentration of leptin was similar in the PC and CG. The concentration of leptin was mainly dependent on body fat mass and fat distribution. Additionally, measurement of waist circumference and body composition was recorded using bioelectrical impedance analysis.. significantly higher concentration levels of adiponectin in the PC group, independent of body fat mass, may play a potential role as a new tumor marker in PC and might be useful in the differential diagnosis between PC and CP, but this statement needs further investigation. To our knowledge, this was the first study evaluating not only body mass index but also the content and distribution of body fat in patients with PC and CP.

Topics: Adiponectin; Adipose Tissue; Adult; Aged; Body Composition; Body Mass Index; CA-19-9 Antigen; Case-Control Studies; Diagnosis, Differential; Electric Impedance; Female; Humans; Leptin; Male; Middle Aged; Pancreatic Neoplasms; Pancreatitis, Chronic; Waist Circumference

Serum leptin and adiponectin determinations have been proposed as markers for distinguishing pancreatic cancer and chronic pancreatitis from autoimmune pancreatitis; however, no studies exist in patients with autoimmune pancreatitis and in those with intraductal papillary mucinous tumors of the pancreas. The aim of this paper was to evaluate the circulating concentrations of receptor for advanced glycation end products (RAGE), leptin and adiponectin in patients with chronic pancreatic diseases.. Seventy-five consecutive patients with chronic pancreatic diseases (47 males, 28 females; mean age 67.0 +/- 13.2 years; range 37-97 years) were studied: six (8.0%) had autoimmune pancreatitis, 23 (30.7%) had chronic pancreatitis, 34 (45.3%) had pancreatic cancer and the remaining 12 (16.0%) had intraductal papillary mutinous tumors of the pancreas. Leptin, adiponectin and RAGE were determined in serum using commercially available kits. The leptin concentrations were normalized to the lower and upper reference limits because of the different gender reference ranges.. Normalized leptin concentrations were significantly lower in chronic pancreatitis patients (0.53 +/- 1.28; p = 0.008) and in those with pancreatic cancer (0.12 +/- 0.33; p < 0.001) compared to the overall population (0.58 +/- 1.23), whereas autoimmune pancreatitis patients had significantly higher concentrations of this protein (2.18 +/- 2.56; p = 0.004) compared to the overall population. RAGE and adiponectin concentrations were similar among the four groups of patients studied. Among the clinical variables considered, only pain was significantly related to leptin concentrations (patients with pain 0.18 +/- 0.54, patients without pain 1.07 +/- 1.64; p = 0.001).. Serum leptin seems to be a good serum marker for differentiating autoimmune pancreatitis patients from those with chronic pancreatitis and pancreatic cancer.

Topics: Adiponectin; Aged; Aged, 80 and over; Autoimmune Diseases; Biomarkers; Diagnosis, Differential; Female; Humans; Leptin; Male; Middle Aged; Pancreatic Neoplasms; Pancreatitis, Chronic; Receptor for Advanced Glycation End Products; Receptors, Immunologic

Resistin is an adipokine, which displays proinflammatory properties. Thus, it is likely that resistin can influence the course of chronic pancreatitis, and/or that chronic pancreatitis may affect the serum resistin concentration.. The aim of the present study was to determine the serum resistin concentration in patients with chronic pancreatitis and to analyze the relationship between serum resistin concentration and serum concentrations of leptin (proinflammatory adipokine) and adiponectin (anti-inflammatory adipokine).. A total of 23 male, nondiabetic patients with chronic pancreatitis of alcoholic origin and 16 healthy subjects were examined. Fasting blood samples were collected from patients in both groups. Serum resistin concentration was assayed by enzyme-linked immunosorbent assay. Serum adiponectin, leptin, and insulin concentrations were determined by radioimmunoassay.. Serum resistin concentration was significantly higher in patients with chronic pancreatitis as compared with control subjects. In contrast, patients with chronic pancreatitis had lower serum leptin and insulin concentrations than healthy subjects. There were no statistically significant differences in serum adiponectin concentration between patients with pancreatitis and healthy subjects.. The results presented in this paper indicate that chronic pancreatitis in human is associated with the increase in serum resistin concentration and with the decrease in serum leptin and insulin concentrations. It can be supposed that resistin, by stimulation of tumor necrosis factor-alpha synthesis in blood mononuclear cells and in macrophages, increases the concentration of tumor necrosis factor-alpha, which in turn activates stellate cells. Activated stellate cells can produce collagen, eventually resulting in the development of pancreatic fibrosis.

Topics: Adiponectin; Adult; Aged; Case-Control Studies; Enzyme-Linked Immunosorbent Assay; Fibrosis; Humans; Insulin; Leptin; Male; Middle Aged; Pancreatitis, Chronic; Radioimmunoassay; Resistin; Tumor Necrosis Factor-alpha

Topics: Adiponectin; Humans; Leptin; Pancreatitis, Alcoholic; Pancreatitis, Chronic

Topics: Adiponectin; Blood Glucose; Humans; Leptin; Pancreatitis, Alcoholic; Pancreatitis, Chronic

The regulation of weight of a body--is an actual problem of modern medicine. The significant part of patients with pathology of gastro-intestinal tract suffers of an increasing weight of a body. In economically advanced countries, including Russia, on the average each third inhabitant has an increasing weight of a body. Last researches shows, that the adipose tissue is not only a place of storage of power stocks, but also analogue endocryne body. The most part of peptides, participating in regulation of food behaviour, in a place of primary development in adipose cells, has been named adipokines. It is possible to attribute to them leptin. The purpose of our research was specification of influence of leptin level on character of a pathology of gastro-pancreato-duodenal zone. Under our supervision there were patients with diseases of gastro-pancreato-duodenal zone: chronic pancreatitis, duodenal ulcer, gastroduodenitis. It was revealed most increasing value of leptin in the patients with combination of chronic pancreatitis and duodenal ulcer.

Topics: Eating; Female; Gastrointestinal Diseases; Humans; Leptin; Male; Pancreatitis, Chronic; Weight Gain

The aim of this study was to assess serum adiponectin and leptin concentrations in patients with chronic pancreatitis of alcoholic and nonalcoholic origin.. Forty-four male patients with chronic pancreatitis of alcoholic origin and 10 patients of nonalcoholic origin as well 16 healthy subjects were examined. Fasting blood samples were collected. Serum adiponectin, leptin, and insulin concentrations were determined by radioimmunoassay methods.. Patients with chronic pancreatitis had lower body mass index values compared with those of control. Nonetheless, there were no differences in serum adiponectin concentration between pancreatitis patients and healthy controls. Pancreatitis patients had lower serum leptin and insulin concentrations than healthy subjects. No difference in serum leptin and insulin concentrations between patients with chronic pancreatitis of alcoholic and nonalcoholic origin was observed. The serum adiponectin/leptin concentration ratio was higher in chronic pancreatitis patients than in control subjects.. Chronic pancreatitis in humans (a) is associated with the decrease in serum leptin and insulin concentrations, (b) does not affect serum adiponectin concentration but increases serum adiponectin/leptin concentration ratio, and (c) alters the interrelationship between serum adiponectin and insulin concentrations. Moreover, these results suggest that changes in serum leptin and insulin concentrations are independent on the etiology of chronic pancreatitis.

Topics: Adiponectin; Adult; Aged; Body Mass Index; Humans; Insulin; Leptin; Male; Middle Aged; Pancreatitis, Alcoholic; Pancreatitis, Chronic; Radioimmunoassay

Previously reported data suggest that serum leptin concentration changes in some acute and chronic inflammatory diseases. The aim of the present study was to assess serum leptin concentration in patients with chronic pancreatitis.. Forty-four male patients with chronic pancreatitis and 16 healthy (male) subjects were examined. Fasting blood samples were collected from patients and healthy controls. Serum leptin and insulin concentrations were determined by radioimmunoassay method.. Significantly lower serum leptin concentration in patients with chronic pancreatitis than in healthy subjects was found. No significant difference in serum leptin concentration between patients without and with exacerbation of chronic pancreatitis on admission was observed. Moreover, patients with chronic pancreatitis had (a) lower serum insulin concentration, (b) higher serum glucose concentration, and (c) lower body mass index than healthy subjects.. The results presented in this article indicate that chronic pancreatitis in humans is associated with the decrease in serum leptin concentration. One can suppose that the decrease in serum insulin concentration, maldigestion, and fat loss all contribute to the decrease of serum leptin concentration in chronic pancreatitis.

Topics: Adult; Aged; Blood Glucose; Body Mass Index; Down-Regulation; Fasting; Humans; Insulin; Leptin; Male; Middle Aged; Pancreatitis, Chronic; Radioimmunoassay; Severity of Illness Index

Leptin alters pancreatic exocrine and beta-cell secretion in animal studies. We hypothesized that leptin might be important in the pathogenesis of idiopathic chronic pancreatitis (ICP) and/or the development of diabetes in ICP.. Fifty patients with ICP (25 with diabetes, 25 without diabetes) and 25 healthy controls were included in a prospective, case-control study. Fasting plasma leptin concentration was measured by enzyme-linked immunosorbent assay. Exocrine and endocrine pancreatic functions were assessed by fecal chymotrypsin and serum C-peptide, respectively. Anthropometric parameters and body fat mass (FM) were measured.. Patients with ICP (mean age, 30 years; 33 men) had significantly lower body mass index (19.5 +/- 2.6 kg/m2) and FM (10.6 +/- 4.2 kg) as compared with controls (body mass index, 21.7 +/- 4.1 kg/m2; FM, 19.0 +/- 16.6 kg; P < 0.01). Fecal chymotrypsin (median, 5.2 [range, 0.3-42.6] U/kg) and C-peptide (median, 1.7 [range, 0.2-9.5] ng/mL) were significantly lower in patients than in controls (12.9 [range, 2.5-33.0] U/kg and 3.5 [range, 0.3-10.3] ng/mL; P < 0.01). Plasma leptin concentration was slightly lower but statistically insignificant in patients with ICP (median, 4.0 [range, 2.0-62.5] ng/mL) as compared with controls (median, 5.0 [range, 2.0-63.0] ng/mL). Patients with and those without diabetes were also comparable with regard to their leptin concentration, pancreatic functions, and anthropometric parameters.. Leptin does not seem to have a pathophysiological role in either ICP or the development of diabetes in ICP.

Topics: Adipose Tissue; Adult; Anthropometry; C-Peptide; Case-Control Studies; Chymotrypsin; Diabetes Mellitus, Type 2; Feces; Female; Humans; Leptin; Male; Middle Aged; Pancreas, Exocrine; Pancreatitis, Chronic; Prospective Studies