Comorbid overweight/obesity and chronic pancreatitis exacerbate the dyslipidemia progression in type 2 diabetic patients

Abstract

Objective. The aim of present study was to analyze the serum lipid profile parameters in patients with type 2 diabetes mellitus (T2DM) and comorbidities [overweight/obesity and/or chronic pancreatitis (CP)] to determine the contribution of these pathologic factors to lipid metabolism disorders in T2DM. Methods. The study involved 579 type 2 diabetic (T2D) patients with comorbid overweight/ obesity and/or CP. The serum lipid panel parameters [total cholesterol (TC), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C)] were determined by commercially available kits on a Cobas 6000 analyzer (Roche Hitachi, Germany). Low-density lipoprotein cholesterol (LDL-C), non-HDL-C, and remnant cholesterol (RC) levels were calculated using formulas. The data were statistically analyzed using STATISTICA 7.0. Results. It was shown that dyslipidemia in T2D patients is characterized by unidirectional changes regardless the presence/absence of comorbid overweight/obesity or CP. At the same time, the most severe dyslipidemia was detected in T2D patients with a combination of comorbid over-weight/obesity and CP. Both the elevated body mass index (BMI) and CP can aggravate lipid metabolism disorders in T2DM. In our study, however, the BMI increase positively correlated with the number of dyslipidemia patients characterized by exceeding all target lipid levels for diabetic patients. This is in contrast to T2D patients with normal body weight and comorbid CP, in whom only LDL-C and TG exceeded the target lipid levels. Conclusions. A combination of comorbidities, such as obesity and CP in T2D patients, produced a mutually aggravating course defined particularly by common pathogenic links, insulin resistance, chronic generalized low-intensity inflammation, endothelial dysfunction, and dyslipidemia caused primarily by triglyceridemia.

Transcriptomic analysis reveals the crosstalk between type 2 diabetes and chronic pancreatitis

“…According to a spectrum analysis of diabetes, in addition to the pathophysiological mechanisms associated with CP, many patients with CP‐related diabetes also have risk factors associated with T2D 10 . Another study showed that the combination of CP and T2D can lead to a mutually aggravating process involving insulin resistance, chronic low‐intensity inflammation, and dyslipidemia 11 . Moreover, compared to comorbidity in CP‐T2D, patients with diabetes related to CP present a more aggressive phenotype (microangiopathy and infection) and higher need for glucose‐lowering treatment, and even patients who experience their first attack of pancreatitis may require long‐term management after being discharged from the hospital 12,13 .…”

“… 10 Another study showed that the combination of CP and T2D can lead to a mutually aggravating process involving insulin resistance, chronic low‐intensity inflammation, and dyslipidemia. 11 Moreover, compared to comorbidity in CP‐T2D, patients with diabetes related to CP present a more aggressive phenotype (microangiopathy and infection) and higher need for glucose‐lowering treatment, and even patients who experience their first attack of pancreatitis may require long‐term management after being discharged from the hospital. 12 , 13 Taken together, CP and T2D exhibit a strong correlation during the progression of the disease.…”

Probiotic co-supplementation with absorbent smectite for pancreatic beta-cell function in type 2 diabetes: a secondary-data analysis of a randomized double-blind controlled trials

“…Between 2000 and 2019, there was a 3% increase in age-standardized mortality rates from diabetes (1). T2D belongs to a group of metabolic diseases inherent in hyperglycemia on the background of insulin resistance (IR) and reduction of insulin secretion (2,3). Chronic hyperglycemia can damage and dysfunctional various organs, such as retinopathy, nephropathy, metabolic and cardiovascular diseases (2,4).…”