Pancreatic function in children with non-alcoholic fatty pancreas disease

Objective. To study the features of pancreatic function in children with pancreatic steatosis. Materials and methods. We examined 77 children; the average age of patients was (11.59 ± 2.82) years. Pancreatic steatosis was diagnosed by ultrasound examination. In addition, shear wave elastography of the pancreas was performed using UltimaPAExpert apparatus («Radmir»,Ukraine). Children were divided into groups according to the obesity/overweight and pancreatic steatosis presence as follows: the group 1–- 47 children with pancreatic steatosis and obesity / overweight; the group 2 – 20 children with obesity / overweight without signs of pancreatic steatosis; the group 3 – 10 children with normal weight who had no signs of steatosis. Examination of the exocrine pancreas function with determination of serum amylase, lipase and trypsin levels, urine amylase, fecal elastase was carried out. Results. Serum lipase level was significantly lower in the group of children with steatosis (0.83 [0.64, 0.99] nmol/s·l) compared to children with normal weight (1.05 [0.99; 1.13] nmol/s·l) (P < 0.05). The level of trypsin did not reveal any significant differences between the groups, while serum amylase level in the patient group 1 tended to be lower compared to children of the group 2. The level of fecal elastase (FE) was significantly lower in patients with steatosis (176.7 [65.8, 251.8] μg/g) compared to children with normal weight (311.40 [213.3, 363. 0] μg/g) (P < 0.05). The level of FE negatively correlated with the degree of pancreatic steatosis in the general group (r = -0,28; P < 0.05) as well as with the pancreatic parenchyma stiffness in children without obesity (r=-0,40; P < 0.05). Conclusions. Pancreatic steatosis in children can be accompanied by exocrine pancreatic insufficiency development.