Pancreatic Elastase Levels in Feces As A Marker of Exocrine Pancreatic Function in Patients With Diabetes Mellitus

Objective: The measurement of pancreatic elastase (PE) in feces is used widely to screen for pancreatic exocrine insufficiency. The aim of our study was to evaluate the relationship of PE with residual beta cell secretion and metabolic control in patients with diabetes mellitus. Method: We determined the presence of PE in specimens via enzyme-linked immunosorbent assay (ELISA), whereas serum fasting glucose, C-peptide, amylase, lipase, triglycerides, total 25(OH)-vitamin D, C-reactive protein (CRP), and hemoglobin A1c (HbA1c) concentrations were assayed using routine laboratory tests. Results: PE values in 48 patients with diabetes were significantly lower than in 24 healthy volunteers (P = .001). In one-third of participants with diabetes mellitus, PE were less than 200 µg per g, indicating pancreatic functional insufficiency. Among the patients in the cohort, PE correlated positively with C-peptide levels (P = .04), lipase (P = .009), CRP (P = .04), sex (P = .03), and BMI (P = .02) but not significantly with duration of diabetes (P = .81) or levels of HbA1c (P = .87), amylase (P = .06), total 25(OH)-vitamin D (P = .16), or triglycerides (P = .52). Conclusion: Our results demonstrated a strong association of diabetes with low PE levels.