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Pancreas Volume Declines During the First Year After Diagnosis of Type 1 Diabetes and Exhibits Altered Diffusion at Disease Onset.

Citation
Virostko, J., et al. “Pancreas Volume Declines During The First Year After Diagnosis Of Type 1 Diabetes And Exhibits Altered Diffusion At Disease Onset.”. Diabetes Care, pp. 248-257.
Center Vanderbilt University
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Author John Virostko, Jon Williams, Melissa Hilmes, Chris Bowman, Jordan Wright, Liping Du, Hakmook Kang, William Russell, Alvin Powers, Daniel Moore
Abstract

OBJECTIVE: This study investigated the temporal dynamics of pancreas volume and microstructure in children and adolescents with recent-onset type 1 diabetes (T1D) and individuals without diabetes, including a subset expressing autoantibodies associated with the early stages of T1D.

RESEARCH DESIGN AND METHODS: MRI was performed in individuals with recent-onset stage 3 T1D ( = 51; median age 13 years) within 100 days after diagnosis (mean 67 days), 6 months, and 1 year postdiagnosis. Longitudinal MRI measurements were also made in similarly aged control participants ( = 57) and in autoantibody-positive individuals without diabetes ( = 20). The MRI protocol consisted of anatomical imaging to determine pancreas volume and quantitative MRI protocols interrogating tissue microstructure and composition.

RESULTS: Within 100 days of diabetes onset, individuals with T1D had a smaller pancreas (median volume 28.6 mL) than control participants (median volume 48.4 mL; < 0.001), including when normalized by individual weight ( < 0.001). Longitudinal measurements of pancreas volume increased in control participants over the year, consistent with adolescent growth, but pancreas volume declined over the first year after T1D diagnosis ( < 0.001). In multiple autoantibody-positive individuals, the pancreas volume was significantly larger than that of the T1D cohort ( = 0.017) but smaller than that of the control cohort ( = 0.04). Diffusion-weighted MRI showed that individuals with recent-onset T1D had a higher apparent diffusion coefficient ( = 0.012), suggesting a loss of cellular structural integrity, with heterogeneous pancreatic distribution.

CONCLUSIONS: These results indicate that pancreas volume is decreased in stages 1, 2, and 3 of T1D and decreases during the first year after diabetes onset and that this loss of pancreatic volume is accompanied by microstructural changes.

Year of Publication
2019
Journal
Diabetes care
Volume
42
Issue
2
Number of Pages
248-257
Date Published
12/2019
ISSN Number
1935-5548
DOI
10.2337/dc18-1507
Alternate Journal
Diabetes Care
PMID
30552135
PMCID
PMC6341292
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