Use of the Electronic Medical Record to Assess Pancreas Size in Type 1 Diabetes

• Published in: PloS one 2016-07, Vol.11 (7), p.e0158825-e0158825
• Main Authors: Virostko, John, Hilmes, Melissa, Eitel, Kelsey, Moore, Daniel J, Powers, Alvin C
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Autoantibodies; Biology and Life Sciences; Body mass; Body mass index; Body size; Body weight; Care and treatment; Computed tomography; Data warehouses; Diabetes mellitus; Diabetes mellitus (insulin dependent); Diabetes Mellitus, Type 1 - diagnostic imaging; Diagnosis; Electronic medical records; Female; Glucose; Health aspects; Health care facilities; Hemoglobin; Humans; Identification methods; Magnetic resonance; Magnetic Resonance Imaging; Male; Medical electronics; Medical imaging; Medical records; Medical Records Systems, Computerized; Medicine and Health Sciences; NMR; Nuclear magnetic resonance; Organ Size; Pancreas; Pancreas, Exocrine - diagnostic imaging; Patients; Prognosis; Research and Analysis Methods; Tomography, X-Ray Computed; Type 1 diabetes; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0158825

This study harnessed the electronic medical record to assess pancreas volume in patients with type 1 diabetes (T1D) and matched controls to determine whether pancreas volume is altered in T1D and identify covariates that influence pancreas volume. This study included 25 patients with T1D and 25 age-, sex-, and weight-matched controls from the Vanderbilt University Medical Center enterprise data warehouse. Measurements of pancreas volume were made from medical imaging studies using magnetic resonance imaging (MRI) or computed tomography (CT). Patients with T1D had a pancreas volume 47% smaller than matched controls (41.16 ml vs. 77.77 ml, P < 0.0001) as well as pancreas volume normalized by subject body weight, body mass index, or body surface area (all P < 0.0001). Pancreatic volume was smaller with a longer duration of T1D across the patient population (N = 25, P = 0.04). Additionally, four individual patients receiving multiple imaging scans displayed progressive declines in pancreas volume over time (~ 6% of volume/year), whereas five controls scanned a year apart did not exhibit a decline in pancreas size (P = 0.03). The pancreas was uniformly smaller on the right and left side of the abdomen. Pancreas volume declines with disease duration in patients with T1D, suggesting a protracted pathological process that may include the exocrine pancreas.