Рівень вазоактивного інтестинального пептиду у хворих на неускладнену дивертикулярну хворобу та його зв’язок із клінічними виявами захворювання

Objective — to investigate the changes in vasoactive intestinal peptide levels in the blood of patients with uncomplicated diverticular disease of the colon, both with normal body weight and obesity, and to assess its potential association with clinical manifestations and the degree of local inflammation. Materials and methods. 18 patients with asymptomatic diverticula and 60 patients with symptomatic diverticular disease (DD), of whom 28 had normal body weight, and 32 had DD combined with obesity. Serum vasoactive intestinal peptide (VIP) levels and fecal calprotectin concentrations were measured in all patients using immunoenzymatic methods. The diagnosis of DD was confirmed by colonoscopy, barium enema, and further specified using abdominal computed tomography. Results. In patients with asymptomatic diverticula, the level of VIP was practically no different from the control (p > 0.05). In the group of symptomatic DD with normal body weight it decreased by 1.41 times (p < 0.01) and in combination with obesity by 2.24 times (p < 0.01). In parallel, the level of fecal calprotectin increased: by 5.74 times with normal body weight and by 7.47 times with obesity (p < 0.01). In the group of asymptomatic diverticula, the indicators exceeded the norm by 3.38 times (p < 0.01). A significant negative correlation was established between the level of VIP and calprotectin (r=–0.71 and r=–0.77; p < 0.0001), as well as between the level of VIP and the size of diverticula (r=–0.73 and r=–0.82; p < 0.0001). In contrast, a positive correlation was found between excess body weight and the level of calprotectin, which indicates the influence of obesity on the intensity of the local inflammatory process. Conclusions. In patients with uncomplicated DD, a significant decrease in the level of VIP was found in combination with an increase in fecal calprotectin, which confirms its anti--inflammatory role in pathogenesis. The severity of changes was more significant in obese patients. The decrease in VIP negatively correlates with the size of diverticula and the severity of clinical manifestations, which allows us to consider this indicator as a potential biomarker of disease progression. A positive correlation between obesity and fecal calprotectin levels has also been established, confirming the role of metabolic disorders in the pathogenesis of DD.