Abnormal
glucose metabolism is present in almost 40% of patients after
acute pancreatitis, but its pathophysiology has been poorly investigated. Pancreatic
hormone derangements have been sparingly studied to date, and their relationship with abnormal
glucose metabolism is largely unknown. The aim was to investigate the associations between
pancreatic hormones and
glucose metabolism after
acute pancreatitis, including the effect of potential confounders. This was a cross-sectional study of 83 adult patients after
acute pancreatitis. Fasting venous blood was collected from all patients and used for analysis of
insulin,
glucagon,
pancreatic polypeptide,
amylin,
somatostatin,
C-peptide,
glucose, and
hemoglobin A1c. Statistical analyses were conducted using the modified Poisson regression, multivariable linear regression, and Spearman's correlation. Age, sex, body mass index, recurrence of
acute pancreatitis, duration from first attack, severity, and etiology were adjusted for. Increased
insulin was significantly associated with abnormal
glucose metabolism after
acute pancreatitis, in both unadjusted (P = 0.038) and adjusted (P = 0.001) analyses. Patients with abnormal
glucose metabolism also had significantly decreased
pancreatic polypeptide (P = 0.001) and increased
amylin (P = 0.047) in adjusted analyses.
Somatostatin,
C-peptide, and
glucagon were not changed significantly in both unadjusted and adjusted analyses. Increased
insulin resistance and reduced
insulin clearance may be important components of hyperinsulinemic compensation in patients after
acute pancreatitis. Increased
amylin and reduced
pancreatic polypeptide fasting levels characterize impaired
glucose homeostasis. Clinical studies investigating islet-cell hormonal responses to mixed-nutrient meal testing and euglycemic-hyperinsulinemic clamps are now warranted for further insights into the role of
pancreatic hormones in
glucose metabolism derangements secondary to
pancreatic diseases.