Dysmicrocirculatory phenomena in patients with acute pancreatitis, concomitant diabetes mellitus, in association with gene polymorphism ENOS (C774T).

Shekh-Ahmed Al-Kubaysi, Alexey Vlasov, Vladimir Trofimov, Tatiana Vlasova, Nina Myshkina, Daria Sardaeva, Alexander Abramov

Al-Kubaysi Sh.S., Vlasov A., Trofimov V., Vlasova T., Myshkina N., Saraeva D., Abramov A. Dysmicrocirculatory phenomena in patients with acute pancreatitis, concomitant diabetesmellitus, in association with gene polymorphism ENOS (C774T). Journal of Clinical Physiology and Pathology (JISCPP) 2024; 3 (1): 19-24.

Despite significant progress in the study of acute pancreatitis (AP), the components of its pathological mechanism are still in active search. Moreover, the risk of its progression and complications increases in the presence of metabolic syndrome, especially diabetes mellitus (DM). In patients with acute pancreatitis and diabetes mellitus, to establish the features of microcirculation disorders in association with polymorphism C774T of the eNOS gene. 56 patients with acute pancreatitis. Depending on the presence of diabetes mellitus, patients are divided into 2 groups: the first – without DM; and the second – with DM. The research methodsincluded the determination of the severity of the disease on the APACHE–II scale, the state of the microcirculatory bed (LACK-02 (Lazma, Russia), and the genetic study of the eNOS gene (C774T) by real-time PCR (CFX96 Touch™ Real-Time PCR DetectionSystem, USA). Follow-up period: 1st, 3rd and 6th days of hospitalization at the clinic. The type of study is a prospective continuous sampling method. Acute pancreatitis in the early stages is accompanied by significant changes in microcirculation in the form of a decrease in tissue perfusion, depression of passive and active processes of regulation of vascular blood flow. These changes were associated with the presence of diabetes mellitus. In this condition, the nature of the disease was severe, and the changes in microcirculation were persistent and untreatable. It has been genetically established that microhemodynamic disorders in acute pancreatitis, with concomitant diabetes mellitus, are closely related to the C774T polymorphism of the eNOS gene. With T/T polymorphism, the degree of microcirculatory changes was recorded at the highest level relative to C/C and C/T and not the reverse. It is necessary to include a molecular examination of patients with AP, including those with diabetes mellitus, at an early stage to predict the risk of exacerbation of the disease and the development of complications.

pancreatitis, diabetes mellitus, C774T, eNOS, microcirculation.