Endothelial Dysfunction in Type IIIc Diabetes Mellitus and Chronic Pancreatitis

Aim and introduction Brachial artery flow mediated dilatation is an index of nitric oxide-dependent endothelial function that is impaired in patients with type 1 and 2 diabetes mellitus. We studied whether there is endothelial dysfunction in diabetes mellitus type IIIc and chronic pancreatitis as compared to normal. Materials and methods We analysed flow mediated dilatation in 31 patients with type IIIc diabetes mellitus (Group A), 34 patients with chronic pancreatitis only (Group B) and 33 age and sex matched controls (Group C) along with history of alcohol or smoking. We also studied flow mediated dilatation in respect to pancreatitis disease phenotype and diabetes mellitus status as evaluated by HbA1c. Results There was a statistically significant difference between groups as determined by oneway ANOVA (F (2, 95) = 68.1, p value 0.0001). A Tukey post hoc test revealed that the mean flow mediated dilatation was statistically significantly lower in group A (2.74±1.28) compared to group B (4.39±1.90) and group C (8.31±2.51, p<0.01). There was statistical difference between group B and C (p<0.01). Mean flow mediated dilatation was significantly lower in alcohol related chronic pancreatitis compared to idiopathic chronic pancreatitis (2.04±0.68% vs. 3.92±1.10%; p<0.05) than controls who are smokers (7.55±1.51%; p value 0.01). Mean flow mediated dilatation was significantly lower in alcohol related chronic pancreatitis (3.15±1.43%) and idiopathic chronic pancreatitis (4.35±1.83%) than controls who are not smokers (8.88±2.97 %; p value <0.01). Conclusion Endothelial dysfunction as assessed by flow mediated dilatation was significantly impaired in chronic pancreatitis and type IIIc diabetes mellitus. Also, there was significant impairment in endothelial dysfunction in alcohol related chronic pancreatitis and those who continue to smoke.

Author(s): Nitin Jagtap, Hrushikesh Chaudhari, Jagadeesh Singh, Rupjyoti Talukdar, Pintu Bhakhar, Mohan Ramchandani, Manu Tandan, DN Reddy

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