Relative Pancreas Volume Is Reduced in Autoantibody Negative First-Degree Relatives and Subjects with Pre–Type 1 Diabetes

Abstract

Pancreatic size is significantly reduced in new-onset type 1 diabetes (T1D) patients and one study reported decreased weight in T1D-related autoantibody (AAb) positive nondiabetic organ donors. We proposed that pancreas volume (PV) could provide important information regarding progression to T1D onset. The relationship between PV and autoantibody status was determined. Study design included 4 groups: T1D patients < 1 year of diagnosis; AAb+ first-degree relatives (FDR); AAb- FDR; and AAb- controls. Fasting subjects underwent pancreas magnetic resonance imaging (MRI) and images were analyzed by radiologists blinded to group. Relative PV (RPV=PV/BMI) was analyzed utilizing a linear mixed model accounting for age, gender, and family clustering with Tukey correction for multiple comparisons. A total of 223 subjects were enrolled with overall age of 19.6±10.5 years (45% males). RPV was significantly higher in controls (n=49) than AAb- FDR (n=60), AAb+ FDR (n=62 (single AAb+ n=30, multiple AAb+ n=32)) and recent onset T1D (n=52) (Figure). RPV was also significantly higher in AAb- FDR and AAb+ FDR vs. recent onset T1D (Figure). Pancreas MRI demonstrates smaller RPV in AAb- FDR than age-matched controls and patients with recent onset T1D have lower RPV than those FDR with established autoimmunity. Pancreas MRI may improve our understanding of the natural history of T1D. Disclosure M. Campbell-Thompson: None. M.A. Atkinson: Other Relationship; Self; Patent Issued. S.L. Filipp: None. M.J. Gurka: None. R. Beegle: None. D. Schatz: None. M.J. Haller: None.