Prevalence and Predictors of Pancreatic Exocrine Insufficiency Among Adults Under 60 Years Presenting with Dyspepsia in Primary Care: A Cross-Sectional Study
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Abstract
Aim: Dyspepsia is one of the most common reasons for consultation in primary care, yet underlying pancreatic exocrine insufficiency (PEI) may remain unrecognized. This study aimed to determine the prevalence of PEI among adults under 60 years presenting with dyspeptic symptoms in primary care and to identify associated sociodemographic, clinical, and symptom-related predictors.
Methods: This cross-sectional study was conducted in the Family Medicine Clinic of a tertiary training and research hospital. A total of 375 adults aged 18–60 years presenting with dyspepsia were included. Data were collected through a structured case report form and the Pancreatic Exocrine Insufficiency Questionnaire (PEI-Q), consisting of A, B, and C subcomponents. PEI positivity was defined according to the questionnaire scoring system. Logistic regression analysis was used to identify independent predictors of PEI positivity. Receiver operating characteristic (ROC) analyses were performed to evaluate the discriminative performance of PEI-Q scores for dyspeptic symptoms.
Results: The mean age of participants was 42.85 ± 11.91 years, and 67.7% were female. Based on PEI-Q results, 32.0% (n = 120) of participants were classified as PEI-positive. PEI positivity was significantly associated with younger age (OR = 0.964), higher body mass index (OR = 1.074), nausea/vomiting (OR = 2.760), epigastric pain (OR = 4.630), and loss of appetite (OR = 4.168). ROC analyses demonstrated moderate discriminative ability of the PEI-Q AB score for nausea/vomiting (AUC = 0.745), epigastric pain (AUC = 0.748), and loss of appetite (AUC = 0.757).
Conclusions: Nearly one-third of adults under 60 years presenting with dyspepsia in primary care were classified as PEI-positive. Specific dyspeptic symptoms, particularly nausea/vomiting, epigastric pain, and loss of appetite, were strongly associated with PEI. The PEI-Q appears to be a practical screening tool for identifying patients at risk of PEI in primary care settings and may contribute to more targeted diagnostic evaluation and management.
