Key clinical point: Patients with rheumatoid arthritis (RA) had worse prognosis after coronary artery bypass grafting surgery (CABG) than matched controls.

Major finding: The risk for mortality at 14.3 years’ follow-up after CABG was significantly higher in patients diagnosed with RA than those without (hazard ratio [HR] 1.50; P < .0001). Moreover, patients with RA were at a higher risk for myocardial infarction during the follow-up period (HR 1.61; P < .0001).

Study details: This was a retrospective analysis of patients with RA (n=378) matched with those without RA (n=7,560), all treated with CABG.

Disclosures: The Finnish Cultural Foundation, the Paulon Säätiö Foundation, the Finnish Governmental VTR-funding, and Suomen Kulttuurirahasto funded this study. The authors disclosed receipt of travel grants, consulting/speaker fees, honoraria, and congress sponsorship from and serving on advisory boards for various sources.

Source: Malmberg M et al. Ann Med. 2021 Aug 31. doi: 10.1080/07853890.2021.1969591.

Key clinical point: Patients with rheumatoid arthritis (RA) had worse prognosis after coronary artery bypass grafting surgery (CABG) than matched controls.

Major finding: The risk for mortality at 14.3 years’ follow-up after CABG was significantly higher in patients diagnosed with RA than those without (hazard ratio [HR] 1.50; P < .0001). Moreover, patients with RA were at a higher risk for myocardial infarction during the follow-up period (HR 1.61; P < .0001).

Study details: This was a retrospective analysis of patients with RA (n=378) matched with those without RA (n=7,560), all treated with CABG.

Disclosures: The Finnish Cultural Foundation, the Paulon Säätiö Foundation, the Finnish Governmental VTR-funding, and Suomen Kulttuurirahasto funded this study. The authors disclosed receipt of travel grants, consulting/speaker fees, honoraria, and congress sponsorship from and serving on advisory boards for various sources.

Source: Malmberg M et al. Ann Med. 2021 Aug 31. doi: 10.1080/07853890.2021.1969591.

Key clinical point: Patients with rheumatoid arthritis (RA) had worse prognosis after coronary artery bypass grafting surgery (CABG) than matched controls.

Major finding: The risk for mortality at 14.3 years’ follow-up after CABG was significantly higher in patients diagnosed with RA than those without (hazard ratio [HR] 1.50; P < .0001). Moreover, patients with RA were at a higher risk for myocardial infarction during the follow-up period (HR 1.61; P < .0001).

Study details: This was a retrospective analysis of patients with RA (n=378) matched with those without RA (n=7,560), all treated with CABG.

Disclosures: The Finnish Cultural Foundation, the Paulon Säätiö Foundation, the Finnish Governmental VTR-funding, and Suomen Kulttuurirahasto funded this study. The authors disclosed receipt of travel grants, consulting/speaker fees, honoraria, and congress sponsorship from and serving on advisory boards for various sources.

Source: Malmberg M et al. Ann Med. 2021 Aug 31. doi: 10.1080/07853890.2021.1969591.

Key clinical point: Joint swelling associated with rheumatoid arthritis (RA) tends to recur in the same joints swollen at RA onset, even in patients who are intensively treated.

Major finding: Overall, 46% of joints swollen at baseline showed swelling recurrence at least once during follow-up. Baseline joint swelling was predictive for swelling during follow-up (odds ratio [OR] 2.37; P < .001) and recurrent, persistent swelling in joints swollen (OR 1.52) and not swollen (OR 1.73) at the previous visit (both P < .001).

Study details: This is a subanalysis of the BeSt (Behandel-Strategieën) study, a treat-to-target trial involving 508 patients with newly diagnosed active RA followed up for a median of 10 years.

Disclosures: The original BeSt study was funded by a research grant from the Dutch College of Health Insurances with additional funding from Schering-Plough BV and Centocor Inc.

Source: Heckert SL et al. Ann Rheum Dis. 2021 Aug 30. doi: 10.1136/annrheumdis-2021-220882.

Key clinical point: Joint swelling associated with rheumatoid arthritis (RA) tends to recur in the same joints swollen at RA onset, even in patients who are intensively treated.

Major finding: Overall, 46% of joints swollen at baseline showed swelling recurrence at least once during follow-up. Baseline joint swelling was predictive for swelling during follow-up (odds ratio [OR] 2.37; P < .001) and recurrent, persistent swelling in joints swollen (OR 1.52) and not swollen (OR 1.73) at the previous visit (both P < .001).

Study details: This is a subanalysis of the BeSt (Behandel-Strategieën) study, a treat-to-target trial involving 508 patients with newly diagnosed active RA followed up for a median of 10 years.

Disclosures: The original BeSt study was funded by a research grant from the Dutch College of Health Insurances with additional funding from Schering-Plough BV and Centocor Inc.

Source: Heckert SL et al. Ann Rheum Dis. 2021 Aug 30. doi: 10.1136/annrheumdis-2021-220882.

Key clinical point: Joint swelling associated with rheumatoid arthritis (RA) tends to recur in the same joints swollen at RA onset, even in patients who are intensively treated.

Major finding: Overall, 46% of joints swollen at baseline showed swelling recurrence at least once during follow-up. Baseline joint swelling was predictive for swelling during follow-up (odds ratio [OR] 2.37; P < .001) and recurrent, persistent swelling in joints swollen (OR 1.52) and not swollen (OR 1.73) at the previous visit (both P < .001).

Study details: This is a subanalysis of the BeSt (Behandel-Strategieën) study, a treat-to-target trial involving 508 patients with newly diagnosed active RA followed up for a median of 10 years.

Disclosures: The original BeSt study was funded by a research grant from the Dutch College of Health Insurances with additional funding from Schering-Plough BV and Centocor Inc.

Source: Heckert SL et al. Ann Rheum Dis. 2021 Aug 30. doi: 10.1136/annrheumdis-2021-220882.

Key clinical point: Passive smoking exposure in childhood is associated with adult-onset seropositive rheumatoid arthritis (RA), suggesting that early life exposures influence RA risk.

Major finding: After adjusting for confounders, maternal smoking during pregnancy was associated with all-incident RA (adjusted hazard ratio [aHR] 1.25; 95% CI 1.03-1.52) and seropositive RA (aHR 1.34; 95% CI 1.06-1.70), whereas childhood parental smoking was associated with seropositive RA (aHR 1.41; 95% CI 1.08-1.83).

Study details: This was an analysis of prospectively collected data from the Nurses’ Health Study II, involving 90,923 women.

Disclosures: This work was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, Rheumatology Research Foundation, and National Institutes of Health. K Yoshida and J Sparks reported receiving research support and consultancy fees from various sources.

Source: Yoshida K et al. Arthritis Rheumatol. 2021 Aug 18. doi: 10.1002/art.41939.

Key clinical point: Passive smoking exposure in childhood is associated with adult-onset seropositive rheumatoid arthritis (RA), suggesting that early life exposures influence RA risk.

Major finding: After adjusting for confounders, maternal smoking during pregnancy was associated with all-incident RA (adjusted hazard ratio [aHR] 1.25; 95% CI 1.03-1.52) and seropositive RA (aHR 1.34; 95% CI 1.06-1.70), whereas childhood parental smoking was associated with seropositive RA (aHR 1.41; 95% CI 1.08-1.83).

Study details: This was an analysis of prospectively collected data from the Nurses’ Health Study II, involving 90,923 women.

Disclosures: This work was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, Rheumatology Research Foundation, and National Institutes of Health. K Yoshida and J Sparks reported receiving research support and consultancy fees from various sources.

Source: Yoshida K et al. Arthritis Rheumatol. 2021 Aug 18. doi: 10.1002/art.41939.

Key clinical point: Passive smoking exposure in childhood is associated with adult-onset seropositive rheumatoid arthritis (RA), suggesting that early life exposures influence RA risk.

Major finding: After adjusting for confounders, maternal smoking during pregnancy was associated with all-incident RA (adjusted hazard ratio [aHR] 1.25; 95% CI 1.03-1.52) and seropositive RA (aHR 1.34; 95% CI 1.06-1.70), whereas childhood parental smoking was associated with seropositive RA (aHR 1.41; 95% CI 1.08-1.83).

Study details: This was an analysis of prospectively collected data from the Nurses’ Health Study II, involving 90,923 women.

Disclosures: This work was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, Rheumatology Research Foundation, and National Institutes of Health. K Yoshida and J Sparks reported receiving research support and consultancy fees from various sources.

Source: Yoshida K et al. Arthritis Rheumatol. 2021 Aug 18. doi: 10.1002/art.41939.

Key clinical point: Combination therapy of methotrexate with tofacitinib or adalimumab improved outcomes in patients with rheumatoid arthritis (RA) who did not respond well to tofacitinib alone.

Major finding: Overall, greater response was achieved by 28.8%, 37.2%, and 39.1% of patients receiving tofacitinib monotherapy, tofacitinib + metotrexate, and adalimumab + methotrexate, respectively. Patients with greater response showed similar 12-month cumulative probability plots for a mean percentage change in Clinical Disease Activity Index across treatment. However, patients with lower responses receiving tofacitinib monotherapy did not respond as well as those receiving combination therapies.

Study details: The data come from a post hoc analysis of the ORAL Strategy trial, which included 1,146 patients with active RA despite methotrexate treatment who were randomly assigned to receive 5 mg tofacitinib twice daily, 5 mg tofacitinib twice daily + methotrexate, or 40 mg adalimumab every other week + methotrexate.

Disclosures: This study was funded by Pfizer Inc. Some of the authors reported receiving grants/research support and consultancy fees from various sources including Pfizer Inc. J Paulissen reported being an employee of Syneos Health. N Iikuni, H Shi, K Soma, and T Hirose reported being employees and shareholders of Pfizer Inc.

Source: Takeuchi T et al. Arthritis Res Ther. 2021 Aug 24. doi: 10.1186/s13075-021-02591-y.

Key clinical point: Combination therapy of methotrexate with tofacitinib or adalimumab improved outcomes in patients with rheumatoid arthritis (RA) who did not respond well to tofacitinib alone.

Major finding: Overall, greater response was achieved by 28.8%, 37.2%, and 39.1% of patients receiving tofacitinib monotherapy, tofacitinib + metotrexate, and adalimumab + methotrexate, respectively. Patients with greater response showed similar 12-month cumulative probability plots for a mean percentage change in Clinical Disease Activity Index across treatment. However, patients with lower responses receiving tofacitinib monotherapy did not respond as well as those receiving combination therapies.

Study details: The data come from a post hoc analysis of the ORAL Strategy trial, which included 1,146 patients with active RA despite methotrexate treatment who were randomly assigned to receive 5 mg tofacitinib twice daily, 5 mg tofacitinib twice daily + methotrexate, or 40 mg adalimumab every other week + methotrexate.

Disclosures: This study was funded by Pfizer Inc. Some of the authors reported receiving grants/research support and consultancy fees from various sources including Pfizer Inc. J Paulissen reported being an employee of Syneos Health. N Iikuni, H Shi, K Soma, and T Hirose reported being employees and shareholders of Pfizer Inc.

Source: Takeuchi T et al. Arthritis Res Ther. 2021 Aug 24. doi: 10.1186/s13075-021-02591-y.

Key clinical point: Combination therapy of methotrexate with tofacitinib or adalimumab improved outcomes in patients with rheumatoid arthritis (RA) who did not respond well to tofacitinib alone.

Major finding: Overall, greater response was achieved by 28.8%, 37.2%, and 39.1% of patients receiving tofacitinib monotherapy, tofacitinib + metotrexate, and adalimumab + methotrexate, respectively. Patients with greater response showed similar 12-month cumulative probability plots for a mean percentage change in Clinical Disease Activity Index across treatment. However, patients with lower responses receiving tofacitinib monotherapy did not respond as well as those receiving combination therapies.

Study details: The data come from a post hoc analysis of the ORAL Strategy trial, which included 1,146 patients with active RA despite methotrexate treatment who were randomly assigned to receive 5 mg tofacitinib twice daily, 5 mg tofacitinib twice daily + methotrexate, or 40 mg adalimumab every other week + methotrexate.

Disclosures: This study was funded by Pfizer Inc. Some of the authors reported receiving grants/research support and consultancy fees from various sources including Pfizer Inc. J Paulissen reported being an employee of Syneos Health. N Iikuni, H Shi, K Soma, and T Hirose reported being employees and shareholders of Pfizer Inc.

Source: Takeuchi T et al. Arthritis Res Ther. 2021 Aug 24. doi: 10.1186/s13075-021-02591-y.

Key clinical point: The combination of filgotinib 200 mg and methotrexate showed an incremental benefit vs. methotrexate monotherapy in methotrexate-naive patients with rheumatoid arthritis (RA) and poor prognostic factors (PPF) with no new safety signals.

Major finding: Among patients with 4 PPFs, methotrexate + 200 mg filgotinib vs. methotrexate monotherapy was associated with higher rates of American College of Rheumatology (ACR) core criteria 20 (85.5% vs. 74.7%), ACR50 (70.3% vs. 48.2%), and ACR70 (54.1% vs. 28.3%) responses at week 24 and weeks 12 and 52 (nominal P < .05 for all).

Study details: This was a post hoc analysis of the phase 3 FINCH 3 study involving 1,249 methotrexate-naive adult patients with moderate-to-severe active RA with multiple PPFs. Patients were randomly assigned to once-weekly methotrexate with once-daily oral filgotinib (200 mg or 100 mg), 200 mg filgotinib monotherapy, or oral methotrexate monotherapy for up to 52 weeks.

Disclosures: The study was funded by Gilead Sciences, Inc. The authors, including the lead author, reported receiving grants, speaker’s fees, and consultancy fees from various sources. Three authors reported being employees and shareholders of Gilead Sciences, Inc.

Source: Aletaha D et al. RMD Open. 2021 Aug 12. doi: 10.1136/rmdopen-2021-001621.

Key clinical point: The combination of filgotinib 200 mg and methotrexate showed an incremental benefit vs. methotrexate monotherapy in methotrexate-naive patients with rheumatoid arthritis (RA) and poor prognostic factors (PPF) with no new safety signals.

Major finding: Among patients with 4 PPFs, methotrexate + 200 mg filgotinib vs. methotrexate monotherapy was associated with higher rates of American College of Rheumatology (ACR) core criteria 20 (85.5% vs. 74.7%), ACR50 (70.3% vs. 48.2%), and ACR70 (54.1% vs. 28.3%) responses at week 24 and weeks 12 and 52 (nominal P < .05 for all).

Study details: This was a post hoc analysis of the phase 3 FINCH 3 study involving 1,249 methotrexate-naive adult patients with moderate-to-severe active RA with multiple PPFs. Patients were randomly assigned to once-weekly methotrexate with once-daily oral filgotinib (200 mg or 100 mg), 200 mg filgotinib monotherapy, or oral methotrexate monotherapy for up to 52 weeks.

Disclosures: The study was funded by Gilead Sciences, Inc. The authors, including the lead author, reported receiving grants, speaker’s fees, and consultancy fees from various sources. Three authors reported being employees and shareholders of Gilead Sciences, Inc.

Source: Aletaha D et al. RMD Open. 2021 Aug 12. doi: 10.1136/rmdopen-2021-001621.

Key clinical point: The combination of filgotinib 200 mg and methotrexate showed an incremental benefit vs. methotrexate monotherapy in methotrexate-naive patients with rheumatoid arthritis (RA) and poor prognostic factors (PPF) with no new safety signals.

Major finding: Among patients with 4 PPFs, methotrexate + 200 mg filgotinib vs. methotrexate monotherapy was associated with higher rates of American College of Rheumatology (ACR) core criteria 20 (85.5% vs. 74.7%), ACR50 (70.3% vs. 48.2%), and ACR70 (54.1% vs. 28.3%) responses at week 24 and weeks 12 and 52 (nominal P < .05 for all).

Study details: This was a post hoc analysis of the phase 3 FINCH 3 study involving 1,249 methotrexate-naive adult patients with moderate-to-severe active RA with multiple PPFs. Patients were randomly assigned to once-weekly methotrexate with once-daily oral filgotinib (200 mg or 100 mg), 200 mg filgotinib monotherapy, or oral methotrexate monotherapy for up to 52 weeks.

Disclosures: The study was funded by Gilead Sciences, Inc. The authors, including the lead author, reported receiving grants, speaker’s fees, and consultancy fees from various sources. Three authors reported being employees and shareholders of Gilead Sciences, Inc.

Source: Aletaha D et al. RMD Open. 2021 Aug 12. doi: 10.1136/rmdopen-2021-001621.

Key clinical point: Fasting C-peptide (FCP) was positively associated with fecal elastase (FE)-1 levels with an independent predictive value for exocrine pancreatic insufficiency (EPI) in patients with type 2 diabetes mellitus (T2DM).

Major finding: Overall, the prevalence of EPI (FE-1 < 200 mg/g) was 18.8%. FE-1 levels were positively associated with FCP levels (correlation coefficient 0.451; P < .001). FCP level was an independent factor (odds ratio 0.204; P = .024) with a good predictive value (area under the receiver operating curve 0.793; sensitivity 0.710; specificity 0.812; P < .001) for EPI.

Study details: Findings are from a cross-sectional analysis of 85 adult inpatients with T2DM without known exocrine pancreatic disorders or digestive system diseases.

Disclosures: This study was supported by the National Natural Science Foundation of China, the Key Research & Development Program of Jiangsu Province, and the Joint Key Project funded by the Southeast University and Nanjing Medical University. The authors declared no conflict of interests.

Source: Lv Y et al. Clin Chim Acta. 2021 Sep 14. doi: 10.1016/j.cca.2021.09.008.

Key clinical point: Fasting C-peptide (FCP) was positively associated with fecal elastase (FE)-1 levels with an independent predictive value for exocrine pancreatic insufficiency (EPI) in patients with type 2 diabetes mellitus (T2DM).

Major finding: Overall, the prevalence of EPI (FE-1 < 200 mg/g) was 18.8%. FE-1 levels were positively associated with FCP levels (correlation coefficient 0.451; P < .001). FCP level was an independent factor (odds ratio 0.204; P = .024) with a good predictive value (area under the receiver operating curve 0.793; sensitivity 0.710; specificity 0.812; P < .001) for EPI.

Study details: Findings are from a cross-sectional analysis of 85 adult inpatients with T2DM without known exocrine pancreatic disorders or digestive system diseases.

Disclosures: This study was supported by the National Natural Science Foundation of China, the Key Research & Development Program of Jiangsu Province, and the Joint Key Project funded by the Southeast University and Nanjing Medical University. The authors declared no conflict of interests.

Source: Lv Y et al. Clin Chim Acta. 2021 Sep 14. doi: 10.1016/j.cca.2021.09.008.

Key clinical point: Fasting C-peptide (FCP) was positively associated with fecal elastase (FE)-1 levels with an independent predictive value for exocrine pancreatic insufficiency (EPI) in patients with type 2 diabetes mellitus (T2DM).

Major finding: Overall, the prevalence of EPI (FE-1 < 200 mg/g) was 18.8%. FE-1 levels were positively associated with FCP levels (correlation coefficient 0.451; P < .001). FCP level was an independent factor (odds ratio 0.204; P = .024) with a good predictive value (area under the receiver operating curve 0.793; sensitivity 0.710; specificity 0.812; P < .001) for EPI.

Study details: Findings are from a cross-sectional analysis of 85 adult inpatients with T2DM without known exocrine pancreatic disorders or digestive system diseases.

Disclosures: This study was supported by the National Natural Science Foundation of China, the Key Research & Development Program of Jiangsu Province, and the Joint Key Project funded by the Southeast University and Nanjing Medical University. The authors declared no conflict of interests.

Source: Lv Y et al. Clin Chim Acta. 2021 Sep 14. doi: 10.1016/j.cca.2021.09.008.

Key clinical point: The prevalence of exocrine pancreatic insufficiency (EPI) was higher in patients with functional dyspepsia (FD) with pancreatic enzyme abnormalities (PEA) compared to asymptomatic patients (AP) with PEA and was associated with physical function but not with the state of anxiety.

Major finding: The prevalence of EPI was higher in patients with FD-PEA vs. AP-PEA (N-benzoyl-L-tyrosyl-p-aminobenzoic acid test scores, 61.67% ± 5.55% vs. 95.38% ± 2.36%; P = .01). Physical component scale was significantly lower in FD-PEA vs. AP-PEA group (44.60 ± 2.40 vs. 53.56 ± 1.31; P = .002). No difference was observed in State-Trait Anxiety Inventory (STAI)-state (P = .089) and STAI-trait (P = .483) scores between groups.

Study details: This study included 49 patients with PEA with (n=20) or without (n=29) symptoms of FD.

Disclosures: This study was funded by the Ministry of Education, Culture, and Science and the Ministry of Health, Japan. The authors declared no conflict of interests.

Source: Agawa S et al. J Clin Biochem Nutr. 2021 Sep 3. doi: 10.3164/jcbn.21-67.

Key clinical point: The prevalence of exocrine pancreatic insufficiency (EPI) was higher in patients with functional dyspepsia (FD) with pancreatic enzyme abnormalities (PEA) compared to asymptomatic patients (AP) with PEA and was associated with physical function but not with the state of anxiety.

Major finding: The prevalence of EPI was higher in patients with FD-PEA vs. AP-PEA (N-benzoyl-L-tyrosyl-p-aminobenzoic acid test scores, 61.67% ± 5.55% vs. 95.38% ± 2.36%; P = .01). Physical component scale was significantly lower in FD-PEA vs. AP-PEA group (44.60 ± 2.40 vs. 53.56 ± 1.31; P = .002). No difference was observed in State-Trait Anxiety Inventory (STAI)-state (P = .089) and STAI-trait (P = .483) scores between groups.

Study details: This study included 49 patients with PEA with (n=20) or without (n=29) symptoms of FD.

Disclosures: This study was funded by the Ministry of Education, Culture, and Science and the Ministry of Health, Japan. The authors declared no conflict of interests.

Source: Agawa S et al. J Clin Biochem Nutr. 2021 Sep 3. doi: 10.3164/jcbn.21-67.

Key clinical point: The prevalence of exocrine pancreatic insufficiency (EPI) was higher in patients with functional dyspepsia (FD) with pancreatic enzyme abnormalities (PEA) compared to asymptomatic patients (AP) with PEA and was associated with physical function but not with the state of anxiety.

Major finding: The prevalence of EPI was higher in patients with FD-PEA vs. AP-PEA (N-benzoyl-L-tyrosyl-p-aminobenzoic acid test scores, 61.67% ± 5.55% vs. 95.38% ± 2.36%; P = .01). Physical component scale was significantly lower in FD-PEA vs. AP-PEA group (44.60 ± 2.40 vs. 53.56 ± 1.31; P = .002). No difference was observed in State-Trait Anxiety Inventory (STAI)-state (P = .089) and STAI-trait (P = .483) scores between groups.

Study details: This study included 49 patients with PEA with (n=20) or without (n=29) symptoms of FD.

Disclosures: This study was funded by the Ministry of Education, Culture, and Science and the Ministry of Health, Japan. The authors declared no conflict of interests.

Source: Agawa S et al. J Clin Biochem Nutr. 2021 Sep 3. doi: 10.3164/jcbn.21-67.

Key clinical point: Patients with diabetes and exocrine pancreatic insufficiency (EPI) had reduced autonomic function compared with those with diabetes without EPI.

Major finding: Overall, the prevalence of EPI (fecal elastase [FE] < 200 mg/g) was 20%. Patients with or without EPI had reduced baroreflex sensitivity (all P < .05) and heart rate variability (P < .05), but not increased frequency of orthostatic hypotension (P = .92).

Study details: This study included 59 patients with type 1 or type 2 diabetes. Patients with diabetes were stratified into EPI (n=8) and control (n=13) groups based on FE levels.

Disclosures: This study was funded by Haukeland University Hospital. The authors declared no conflict of interests.

Source: Sangnes DA et al. Scand J Gastroenterol. 2021 Sep 7. doi: 10.1080/00365521.2021.1957496.

Key clinical point: Patients with diabetes and exocrine pancreatic insufficiency (EPI) had reduced autonomic function compared with those with diabetes without EPI.

Major finding: Overall, the prevalence of EPI (fecal elastase [FE] < 200 mg/g) was 20%. Patients with or without EPI had reduced baroreflex sensitivity (all P < .05) and heart rate variability (P < .05), but not increased frequency of orthostatic hypotension (P = .92).

Study details: This study included 59 patients with type 1 or type 2 diabetes. Patients with diabetes were stratified into EPI (n=8) and control (n=13) groups based on FE levels.

Disclosures: This study was funded by Haukeland University Hospital. The authors declared no conflict of interests.

Source: Sangnes DA et al. Scand J Gastroenterol. 2021 Sep 7. doi: 10.1080/00365521.2021.1957496.

Key clinical point: Patients with diabetes and exocrine pancreatic insufficiency (EPI) had reduced autonomic function compared with those with diabetes without EPI.

Major finding: Overall, the prevalence of EPI (fecal elastase [FE] < 200 mg/g) was 20%. Patients with or without EPI had reduced baroreflex sensitivity (all P < .05) and heart rate variability (P < .05), but not increased frequency of orthostatic hypotension (P = .92).

Study details: This study included 59 patients with type 1 or type 2 diabetes. Patients with diabetes were stratified into EPI (n=8) and control (n=13) groups based on FE levels.

Disclosures: This study was funded by Haukeland University Hospital. The authors declared no conflict of interests.

Source: Sangnes DA et al. Scand J Gastroenterol. 2021 Sep 7. doi: 10.1080/00365521.2021.1957496.

Key clinical point: High prevalence of exocrine pancreatic insufficiency (EPI)-related fat malabsorption was observed in Asian Indian patients with type 2 diabetes mellitus (T2DM), which was significantly associated with autonomic dysfunction.

Major finding: EPI-related fat malabsorption (72 hours fecal fat > 18 g) was present in 44.9% and 6.1% of patients with and without T2DM, respectively (P < .05). Among patients with T2DM, those with or without EPI-related fat malabsorption had significantly higher proportion of parasympathetic nervous system (PNS) dysfunction (86.7% vs. 61.5%), sympathetic nervous system (SNS) dysfunction (92.4% vs. 72.3%), and PNS+SNS dysfunction (83.1 vs. 66.0%; all P < .05).

Study details: Findings are from a cross-sectional analysis of 118 patients with T2DM and 82 normoglycemic individuals.

Disclosures: This study was supported by the FLUID research grant of CMC, Vellore, India. The authors declared no conflict of interests.

Source: Anoop S et al. Diab Metab Syndr Clin Res Rev. 2021 Sep 4. doi: 10.1016/j.dsx.2021.102273.

Key clinical point: High prevalence of exocrine pancreatic insufficiency (EPI)-related fat malabsorption was observed in Asian Indian patients with type 2 diabetes mellitus (T2DM), which was significantly associated with autonomic dysfunction.

Major finding: EPI-related fat malabsorption (72 hours fecal fat > 18 g) was present in 44.9% and 6.1% of patients with and without T2DM, respectively (P < .05). Among patients with T2DM, those with or without EPI-related fat malabsorption had significantly higher proportion of parasympathetic nervous system (PNS) dysfunction (86.7% vs. 61.5%), sympathetic nervous system (SNS) dysfunction (92.4% vs. 72.3%), and PNS+SNS dysfunction (83.1 vs. 66.0%; all P < .05).

Study details: Findings are from a cross-sectional analysis of 118 patients with T2DM and 82 normoglycemic individuals.

Disclosures: This study was supported by the FLUID research grant of CMC, Vellore, India. The authors declared no conflict of interests.

Source: Anoop S et al. Diab Metab Syndr Clin Res Rev. 2021 Sep 4. doi: 10.1016/j.dsx.2021.102273.

Key clinical point: High prevalence of exocrine pancreatic insufficiency (EPI)-related fat malabsorption was observed in Asian Indian patients with type 2 diabetes mellitus (T2DM), which was significantly associated with autonomic dysfunction.

Major finding: EPI-related fat malabsorption (72 hours fecal fat > 18 g) was present in 44.9% and 6.1% of patients with and without T2DM, respectively (P < .05). Among patients with T2DM, those with or without EPI-related fat malabsorption had significantly higher proportion of parasympathetic nervous system (PNS) dysfunction (86.7% vs. 61.5%), sympathetic nervous system (SNS) dysfunction (92.4% vs. 72.3%), and PNS+SNS dysfunction (83.1 vs. 66.0%; all P < .05).

Study details: Findings are from a cross-sectional analysis of 118 patients with T2DM and 82 normoglycemic individuals.

Disclosures: This study was supported by the FLUID research grant of CMC, Vellore, India. The authors declared no conflict of interests.

Source: Anoop S et al. Diab Metab Syndr Clin Res Rev. 2021 Sep 4. doi: 10.1016/j.dsx.2021.102273.

Key clinical point: Blood specimens from patients with chronic pancreatitis (CP) yielded a panel of 6 metabolites that showed differential expression with the presence or absence of exocrine pancreatic insufficiency (EPI;

Key clinical point: Presence of insulin resistance did not change the fecal elastase-1 (FE-1) levels or the rate of exocrine pancreatic insufficiency (EPI) in patients with obesity.

Major finding: Mean FE-1 levels (430.27 ± 207.63 vs. 508.64 ± 188.77; P = .119) and the rate of EPI (FE-1 < 200 mg/g; 25.7% vs. 10.0%; P = .104) were not significantly different in patients with or without insulin resistance.

Study details: Findings are from a retrospective analysis of 65 patients with obesity (body mass index, >30 kg/m²) with (n=35) or without (n=30) insulin resistance.

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Uysal BB et al. Med Sci. 2021 Aug 23. doi: 10.5455/medscience.2021.05.164.

Key clinical point: Blood specimens from patients with chronic pancreatitis (CP) yielded a panel of 6 metabolites that showed differential expression with the presence or absence of exocrine pancreatic insufficiency (EPI;

Key clinical point: Presence of insulin resistance did not change the fecal elastase-1 (FE-1) levels or the rate of exocrine pancreatic insufficiency (EPI) in patients with obesity.

Major finding: Mean FE-1 levels (430.27 ± 207.63 vs. 508.64 ± 188.77; P = .119) and the rate of EPI (FE-1 < 200 mg/g; 25.7% vs. 10.0%; P = .104) were not significantly different in patients with or without insulin resistance.

Study details: Findings are from a retrospective analysis of 65 patients with obesity (body mass index, >30 kg/m²) with (n=35) or without (n=30) insulin resistance.

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Uysal BB et al. Med Sci. 2021 Aug 23. doi: 10.5455/medscience.2021.05.164.

Key clinical point: Blood specimens from patients with chronic pancreatitis (CP) yielded a panel of 6 metabolites that showed differential expression with the presence or absence of exocrine pancreatic insufficiency (EPI;

Key clinical point: Presence of insulin resistance did not change the fecal elastase-1 (FE-1) levels or the rate of exocrine pancreatic insufficiency (EPI) in patients with obesity.

Major finding: Mean FE-1 levels (430.27 ± 207.63 vs. 508.64 ± 188.77; P = .119) and the rate of EPI (FE-1 < 200 mg/g; 25.7% vs. 10.0%; P = .104) were not significantly different in patients with or without insulin resistance.

Study details: Findings are from a retrospective analysis of 65 patients with obesity (body mass index, >30 kg/m²) with (n=35) or without (n=30) insulin resistance.

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Uysal BB et al. Med Sci. 2021 Aug 23. doi: 10.5455/medscience.2021.05.164.