ENDOCRINE FUNCTION OF THE PANCREAS IN GASTRO-DUODENAL PATHOLOGY ASSOCIATED WITH HELICOBACTER PYLORI INFECTION IN CHILDREN

Aim. To assess endocrine function of the pancreas in children with gastro-duodenal pathology associated with Helicobacter pylori. Material and Methods. The study involved 76 children with gastro-duodenal pathology associated with Helicobacter pylori infection. Fifty nine children with the gastro-duodenal diseases without Helicobacter pylori infection served as controls. To verify the primary diagnosis all children underwent flexible endoscopy of the esophagus, stomach and duodenum. Endocrine pancreatic function was evaluated by serum glucose test and fasting C-peptide. Results and Discussion. In the examined 135 children we found 20% overweight. Historically, almost 10% of the children had 1st and 2nd degree relatives with diabetes mellitus type I and II, and Helicobacter pylori infection regardless of their diabetic status. Fasting serum glucose levels fell within normal limits in all children. At the same time, concentration of C-peptide was out of normal limits in one third of patients in both groups. It was observed that level of C-peptide often exceeded the upper limit values in patients with Helicobacter pylori infection (27.5%) compared with uninfected individuals (8.9%) with (p<0,05). In Helicobacter pylori negative patients C-peptide showed a tendency towards reduction in 20.0% of cases, while Helicobacter pylori positive patients had a slight decrease in this variable in 7.5%. The median concentration of Cpeptide in the group I was 1.2 ng /ml at median confidence interval 1,06-2,15 ng /ml, and for the group II - 0.71 ng /ml at median confidence interval 0,59-1,12 ng /ml (p<0,05). Conclusion. The present data suggest that gastro-duodenal pathology often results in functional changes of endocrine pancreatic function. The identified variations can be considered "functional", but they require follow-up, as well as lifestyle changes and body weight management in overweight children to prevent the possible development of diabetes. Keywords: gastro-duodenal pathology, Helicobacter pylori, endocrine function, pancreas, children