title: Pancreatic volume and endocrine and exocrine functions in patients with diabetes.
abstract: OBJECTIVE
  Exocrine function has been described in patients with diabetes. We hypothetized that patients with exocrine dysfunction have pancreatic atrophy.
  
  
  METHODS
  This is a cohort study of hospitalized patients. Thirty-five patients were selected after detection of impaired exocrine function in routine tests, and 17 patients were matched for age and body mass index to the previous cohort. The pancreatic volume was evaluated on sections of computed tomographic scans of the pancreas. Other investigations included a glucagon stimulation test and determination of fecal elastase-1 concentration and chymotrypsin activity.
  
  
  RESULTS
  Fifty-two patients participated in this study, 24 with type 1 diabetes and 28 with type 2 diabetes. Duration of diabetes was 15 years (5-26 years; median [interquartile range]). The pancreatic volume, 42 cm (25-57 cm), was decreased in most patients. It did not differ in patients with type 1 diabetes compared with those with type 2 diabetes. It was decreased in patients treated with insulin and in those with low elastase-1 concentration or low chymotrypsin activity. In the multiple linear regression analysis, the pancreatic volume correlated with chymotrypsin activity and stimulated C-peptide.
  
  
  CONCLUSIONS
  We have unraveled a link between 2 old observations in patients with diabetes: atrophy of the pancreas and exocrine deficiency. These observations give credence to the reality of the exocrine dysfunction in patients with diabetes.
authors.affiliation: Service de Diabétologie, Hôtel Dieu de Paris, France.
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Philippe
authors.forename: Salim
authors.initials: S
authors.lastname: Benabadji
authors.forename: Laurence
authors.initials: L
authors.lastname: Barbot-Trystram
authors.forename: Dominique
authors.initials: D
authors.lastname: Vadrot
authors.forename: Christian
authors.initials: C
authors.lastname: Boitard
authors.forename: Etienne
authors.initials: E
authors.lastname: Larger
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy / Q000473:pathology; D002096:C-Peptide / Q000097:blood; D002918:Chymotrypsin / Q000032:analysis; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000473:pathology* / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology* / Q000503:physiopathology*; D005243:Feces / Q000201:enzymology; D005260:Female; D005934:Glucagon; D006801:Humans; D007515:Islets of Langerhans / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D046790:Pancreas, Exocrine / Q000473:pathology / Q000503:physiopathology; D010196:Pancreatic Elastase / Q000032:analysis; D014057:Tomography, X-Ray Computed
chemical_list: D002096:C-Peptide; D005934:Glucagon; D002918:Chymotrypsin; D010196:Pancreatic Elastase