Evaluation of exocrine pancreatic function in pregnant women with gestational diabetes

Gestational diabetes (GD) is a consequence of physiologically determined insulin resistance in pregnant women aimed for adequate fetal growth maintenance. The frequency of GD has no tendency to decrease. Endocrine and exocrine parts of the pancreas are in anatomical and functional interaction, therefore, investigation of not only pancreatic islet but also acinar complex functioning in women with GD is becoming an urgent issue in modern pregnancy management. Aim - to investigate the state of pancreatic exocrine function in pregnant women with GD. Materials and methods. 104 women took part in our research. Serum levels of pancreatic lipase and amylase together with fecal elastase-1 (FE-1) concentration were evaluated. Statistically significant difference between groups was confirmed at the Student's test criterion value p≤0.05. Results. Pregnant women with GD had significantly lower levels of serum pancreatic enzymes amylase (25.9±7.5 U/l compared to 35.1±6.8 U/l in the control group) and lipase (40.6±9.8 U/l compared to 61.9±10.5 U/l in the control group), as well as FE-1 levels (294.4±64.3 μmol/l compared to 368.1±62.1 μmol/l in the control group). A positive correlation between the level of pancreatic enzymes and the level of FE-1 was established, as well as a negative relationship between the level of FE-1 and pregnancy term. Conclusions. GD is characterized by a decrease in pancreatic exocrine function, which worsens with increasing gestational term and can be diagnosed by measuring serum levels of amylase and lipase, as well as FE-1. The study was conducted in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the local ethics committee of the participating institution. Informed consent was obtained from all patients. No conflict of interests was declared by the authors.