In order to clarify the relationship between radiographic changes in the pancreatic duct by ERCP and pancreatic endocrine function, the 100g oral glucose tolerance test (GTT) and arginine tolerance test (ATT) for the evaluation of pancreatic endocrine function were performed in 65 patients with chronic pancreatitis, and in five control subjects with normal pancreatogram and glucose tolerance. The patients with chronic pancreatitis were divided into three groups according to ERCP findings (advanced pancreatitis: ADP, n=7, moderate pancreatitis: MOP, n=35, minimal pancreatitis: MIP, n=23).
The sum of glucose levels at basal, 30, 60, 90, and 120 min during 100g OGTT in the ADP group was significantly higher than that in the MOP and MIP groups or controls. The ratio of increments of plasma insulin (IRI) above basal level at 30 min to that of glucose (insulinogenic index) during GTT was significantly lower in each type of chronic pancreatitis tham in controls. On the other hand the ratio of the sum of IRI increments above basal level at 30, 60, 90 and 120 min to that of glucose (ΣΔIRI/ΣΔBS) during GTT in each type of chronic pnancreatitis was not significantly different from controls. However, both indices in each subgroup consisting of patients with diabetic gluose tolerance were significantly lower than in controls. There were no significant differences in the sum of increments of both IRI (ΣΔIRI) and glucagon (ΣΔIRG) for 2 hours during ATT in the MIP, MOP or ADP group in comparison with controls. However, ΣΔ IRG during ATT in the ADP group was significantly lower than that in the MOP group. These results suggest that glucose intolerance in ADP is associated with decreased insulin secretion, and that pancreatographic changes in MIP or MOP are not correlated with pancreatic endocrine function.