Зміни показників калікреїн-кінінової системи та ендогенної інтоксикації у хворих на хронічний панкреатит із супутнім цукровим діабетом

Introduction. The kinin–kallikrein system and endogenous intoxication play an important role in the course of chronic pancreatitis (CP) with concomitant diabetes mellitus.The aim of the study – to investigate the effect of diabetes mellitus on the parameters of the kinin–kallikrein system and endotoxicosis in patients with CP.Research Methods. The study involved 112 patients with CP who were divided into 2 groups: 1st group – 35 patients with CP without diabetes; 2nd group – 77 patients with CP with concomitant diabetes.Results and Discussion. A statistically significant higher level of activation of total proteolysis by the level of proteolytic activity in patients with CP and DM was found, as compared with the group of patients with CP and control group and the increase of specific proteolysis by the level of the protease enzyme of kallikrein, which had a similar trend to proteolytic activity in patients with CP and DM. Reductions in the inactive precursor kallikrein – prekallikrein, which was lowered in the 2nd group of patients compared with the 1st group and the control group, was revealed. A decrease in the activity of kininase – 2nd in patients with chronic obstructive pulmonary disease and CP with diabetes mellitus was established against control, indicating weakening of the body's protective reactions due to excessive production of kinins. The level of medium molecular weight peptides (MM WP) in the blood of patients with CP was statistically higher compared with the control group. The values of both MM WP254 and MM WP280 were statistically increased in patients with CP with concomitant diabetes, as compared with the group of patients with chronic hypotensive disease (p<0.05).Conclusions. A statistically significant activation of proteolytic activity, increase of the proteolytic enzyme of the kallikrein, decrease of the prekallikrein level, increase of the α1-proteinase inhibitor and α2-macroglobulin levels and decrease of the kininase-II activity, an increase in endotoxicosis in patients with CP with concomitant diabetes (p<0.05) compared to patients with only CP have been proved. This ascertains a complicating role of injury of kininkallikrein system in comorbidity of CP and diabetes.