Pediatrics Department, Faculty of Medicine, Ain Shams University, Qorash Street, Nasr City, Cairo, 11765, Egypt.
Radiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Pediatr Radiol. 2022 Nov;52(12):2348-2358. doi: 10.1007/s00247-022-05363-1. Epub 2022 Apr 23.
Little is known about changes in the pancreas as the course of type 1 diabetes progresses. Recently, shear wave elastography (SWE) emerged as a tool for assessing pancreatic stiffness in chronic pancreatitis and pancreatic cancer with a few studies assessing it in diabetes.
To compare pancreatic SWE in children with recent-onset and long-standing type 1 diabetes to healthy controls and to correlate it with diabetes duration, glycated hemoglobin (HbA1C), functional B cell reserve (fasting C-peptide) and diabetic complications.
Fifty children with type 1 diabetes (25 with recent-onset and 25 with long-standing type 1 diabetes) and 50 controls were enrolled. Diabetes duration, insulin therapy, fundoscopic examination of the eyes and the neuropathy disability score were assessed. Fasting C-peptide, lipids, HbA1C and urinary albumin-creatinine ratio were measured. Pancreatic SWE was measured using the General Electric Logiq P9 ultrasound system.
The mean SWE of the studied children with recent-onset type 1 diabetes was 4.81±0.62 kilopascals (Kpa), those with long-standing type 1 diabetes was 7.10±1.56Kpa and for controls was 5.57±0.27 Kpa (P<0.001). SWE was positively correlated to diabetes duration (P<0.001) and negatively correlated to fasting C-peptide (P<0.001). Regarding diabetes complications, SWE was positively correlated to frequency of severe hypoglycemia (P=0.005), HbA1C (P=0.03), low-density lipoproteins (P<0.001) and cholesterol (P<0.001) and significantly related to diabetic neuropathy (P=0.04) and nephropathy (P=0.05). Diabetes duration, fasting C-peptide, HbA1C and frequency of severe hypoglycemia were the significant independent variables related to SWE increase by multivariable regression analysis.
Pancreatic SWE changes significantly with duration of type 1 diabetes, being lowest in those with recent-onset type 1 diabetes and highest in those with long-standing type 1 diabetes, particularly those with diabetic nephropathy and neuropathy.
人们对 1 型糖尿病病程中胰腺变化知之甚少。最近，剪切波弹性成像（SWE）作为一种评估慢性胰腺炎和胰腺癌胰腺硬度的工具出现，一些研究也评估了它在糖尿病中的应用。
比较新发和长期 1 型糖尿病患儿与健康对照组的胰腺 SWE，并将其与糖尿病病程、糖化血红蛋白（HbA1C）、功能性 B 细胞储备（空腹 C 肽）和糖尿病并发症相关联。
共纳入 50 例 1 型糖尿病患儿（25 例新发，25 例长期）和 50 例对照组。评估糖尿病病程、胰岛素治疗、眼底检查和神经病变残疾评分。检测空腹 C 肽、血脂、HbA1C 和尿白蛋白/肌酐比值。使用通用电气 Logiq P9 超声系统测量胰腺 SWE。
新发 1 型糖尿病患儿的平均 SWE 为 4.81±0.62kPa，长期 1 型糖尿病患儿的 SWE 为 7.10±1.56kPa，对照组的 SWE 为 5.57±0.27kPa（P＜0.001）。SWE 与糖尿病病程呈正相关（P＜0.001），与空腹 C 肽呈负相关（P＜0.001）。关于糖尿病并发症，SWE 与严重低血糖发作频率呈正相关（P=0.005）、HbA1C（P=0.03）、低密度脂蛋白（P＜0.001）和胆固醇（P＜0.001）显著相关，且与糖尿病神经病变（P=0.04）和肾病（P=0.05）显著相关。多变量回归分析显示，糖尿病病程、空腹 C 肽、HbA1C 和严重低血糖发作频率是 SWE 增加的显著独立相关因素。
1 型糖尿病患儿的胰腺 SWE 随病程显著变化，新发 1 型糖尿病患儿的 SWE 最低，长期 1 型糖尿病患儿的 SWE 最高，尤其是有糖尿病肾病和神经病变的患儿。
