Pancreas volume in health and disease: a systematic review and meta-analysis

ABSTRACT Introduction: The pancreas plays a central role in metabolism and is involved in the pathogenesis of several diseases. Pancreas volume is a holistic quantitative measure of pancreas size but the clinical relevance of pancreas volumetry is poorly understood. Areas covered: The aim was to systematically review studies in adults that used computed tomography or magnetic resonance imaging to measure pancreas volume in health and disease, to determine normal pancreas volume range, and to quantify changes in pancreas volume that are associated with disease. Expert commentary: The normal pancreas volume range in adults is 71–83 cm3, with no statistically significant difference between men and women. Type 2 diabetes and type 1 diabetes are associated with a progressively reduced pancreas volume. Overweight and obesity are associated with a progressively increased pancreas volume. There is a paucity of studies on pancreas volume in the setting of diseases of the exocrine pancreas, which should become a research priority in the future.

[1]  C. Boitard,et al.  Pancreatic Volume and Endocrine and Exocrine Functions in Patients With Diabetes , 2011, Pancreas.

[2]  Endocrine and Exocrine Functions of the Pancreas , 2019 .

[3]  D. Mašulović,et al.  CT volumetry of normal pancreas: correlation with the pancreatic diameters measurable by the cross-sectional imaging, and relationship with the gender, age, and body constitution , 2012, Surgical and Radiologic Anatomy.

[4]  Ruma G. Singh,et al.  Cross‐talk between innate cytokines and the pancreatic polypeptide family in acute pancreatitis , 2017, Cytokine.

[5]  J. D. De Mey,et al.  Islet Cell Survival Determined by Morphology An Immunocytochemical Study of the Islets of Langerhans in Juvenile Diabetes Mellitus , 1978, Diabetes.

[6]  Roy Taylor,et al.  Morphology of the pancreas in type 2 diabetes: effect of weight loss with or without normalisation of insulin secretory capacity , 2016, Diabetologia.

[7]  C. Dayan,et al.  Pancreatic volume is reduced in adult patients with recently diagnosed type 1 diabetes. , 2012, The Journal of clinical endocrinology and metabolism.

[8]  R. Pozzi Mucelli,et al.  Autoimmune pancreatitis: pancreatic and extrapancreatic MR imaging-MR cholangiopancreatography findings at diagnosis, after steroid therapy, and at recurrence. , 2011, Radiology.

[9]  Steve V. DeSouza,et al.  Pancreas shrinkage following recurrent acute pancreatitis: an MRI study , 2019, European Radiology.

[10]  J. Windsor,et al.  Ethnic and geographic variations in the incidence of pancreatitis and post-pancreatitis diabetes mellitus in New Zealand: a nationwide population-based study. , 2017, The New Zealand medical journal.

[11]  Jaelim Cho,et al.  Abdominal obesity and insulin resistance after an episode of acute pancreatitis. , 2018, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[12]  K. Jain,et al.  Normal organ volume assessment from abdominal CT , 2004, Abdominal Imaging.

[13]  R. Bergman,et al.  Accurate Assessment of β-Cell Function: The Hyperbolic Correction , 2002 .

[14]  Victor Couture,et al.  Appendix for online publication , 2007 .

[15]  E. Sasaki,et al.  Pancreatic volume in type 1 und type 2 diabetes mellitus , 2001, Acta Diabetologica.

[16]  C. Begg,et al.  Operating characteristics of a rank correlation test for publication bias. , 1994, Biometrics.

[17]  E. Libon,et al.  The density, contour, and thickness of the pancreas in diabetics: CT findings in 57 patients. , 1992, AJR. American journal of roentgenology.

[18]  J. Windsor,et al.  The Role of Gut–brain Axis in Regulating Glucose Metabolism After Acute Pancreatitis , 2017, Clinical and translational gastroenterology.

[19]  J. Kleeff,et al.  Volumetric gain of the human pancreas after left partial pancreatic resection: A CT-scan based retrospective study. , 2015, Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.].

[20]  Sung‐Gyu Lee,et al.  Pancreatic Atrophy Relative to External Versus Internal Drainage of the Pancreatic Duct After Pylorus-Preserving Pancreaticoduodenectomy , 2014, Journal of Gastrointestinal Surgery.

[21]  Sakina H. Bharmal,et al.  Profile of Gut Hormones, Pancreatic Hormones and Pro-inflammatory Cytokines in New Zealand Maori , 2018, Gastroenterology research.

[22]  J. Ghali,et al.  Lack of Trophic Pancreatic Effects in Humans With Long-term Administration of Ximelagatran , 2006, Pancreas.

[23]  Steve V. DeSouza,et al.  Quantitative determination of pancreas size using anatomical landmarks and its clinical relevance: A systematic literature review , 2018, Clinical anatomy.

[24]  M. Goodarzi,et al.  Relationship between circulating levels of pancreatic proteolytic enzymes and pancreatic hormones. , 2017, Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.].

[25]  J. Meigs,et al.  Links Between Ectopic Fat and Vascular Disease in Humans , 2014, Arteriosclerosis, thrombosis, and vascular biology.

[26]  J. Windsor,et al.  New‐Onset Diabetes After Acute and Critical Illness: A Systematic Review , 2017, Mayo Clinic proceedings.

[27]  J. Florez,et al.  Differences in pancreatic volume, fat content, and fat density measured by multidetector-row computed tomography according to the duration of diabetes , 2014, Acta Diabetologica.

[28]  B H Frank,et al.  Quantitative study of insulin secretion and clearance in normal and obese subjects. , 1988, The Journal of clinical investigation.

[29]  Jun-xi Lu,et al.  Pancreatic volume is reduced in patients with latent autoimmune diabetes in adults , 2016, Diabetes/metabolism research and reviews.

[30]  L. Schumm,et al.  Pancreas Size and Volume on Computed Tomography in Normal Adults , 2012, Pancreas.

[31]  K. Tomaszewski,et al.  The Vascular Microarchitecture of the Human Fetal Pancreas: A Corrosion Casting and Scanning Electron Microscopy Study , 2017, Pancreas.

[32]  Roy Taylor,et al.  Altered Volume, Morphology and Composition of the Pancreas in Type 2 Diabetes , 2015, PloS one.

[33]  Yoichi Matsuo,et al.  Factors that predict the occurrence of and recovery from non-alcoholic fatty liver disease after pancreatoduodenectomy. , 2016, Surgery.

[34]  R. Pandey,et al.  Body Fat Patterning, Hepatic Fat and Pancreatic Volume of Non-Obese Asian Indians with Type 2 Diabetes in North India: A Case-Control Study , 2015, PloS one.

[35]  J. R. Henderson,et al.  The pancreas as a single organ: the influence of the endocrine upon the exocrine part of the gland. , 1981, British medical journal.

[36]  J. Windsor,et al.  Interleukin-6 is associated with chronic hyperglycemia and insulin resistance in patients after acute pancreatitis. , 2016, Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.].

[37]  Y. Gonul,et al.  Age-related volumetric changes in pancreas: a stereological study on computed tomography , 2012, Surgical and Radiologic Anatomy.

[38]  M. Petrov,et al.  Calcitonin gene-related peptide: neuroendocrine communication between the pancreas, gut, and brain in regulation of blood glucose. , 2017, Annals of translational medicine.

[39]  L. Plank,et al.  Ectopic fat accumulation in the pancreas and its clinical relevance: A systematic review, meta-analysis, and meta-regression. , 2017, Metabolism: clinical and experimental.

[40]  V. Grill,et al.  Pancreas size and insulin secretion: lack of association in non-diabetic subjects , 1996, Acta Diabetologica.

[41]  S. Poppitt,et al.  Ectopic fat accumulation in the pancreas and its biomarkers: A systematic review and meta‐analysis , 2017, Diabetes/metabolism research and reviews.

[42]  E. Rummeny,et al.  Influence of Sorafenib and Bevacizumab on pancreatic volume - A monocentric CT based analysis. , 2016, Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.].

[43]  S. Higuchi,et al.  Pancreatic Volume Associated with Endocrine and Exocrine Function of the Pancreas among Japanese Alcoholics , 2005, Pancreatology.

[44]  W. Uhl,et al.  Reduced pancreatic volume and beta-cell area in patients with chronic pancreatitis. , 2009, Gastroenterology.

[45]  Errol Colak,et al.  Pancreas volume measurement in patients with Type 2 diabetes using magnetic resonance imaging-based planimetry. , 2014, Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.].

[46]  M. Petrov.  Skeletal muscle: A new piece in the pancreatitis puzzle , 2019, United European gastroenterology journal.

[47]  M. Petrov,et al.  Diabetes of the exocrine pancreas: American Diabetes Association-compliant lexicon. , 2017, Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.].

[48]  T. Ito,et al.  Three-dimensional computed tomographic volumetric changes in pancreas before and after living donor surgery for pancreas transplantation: effect of volume on glucose metabolism. , 2014, Transplantation proceedings.

[49]  D. Stallknecht.  FACT SHEET , 2006 .

[50]  I. Goldfine,et al.  Insulin, via Its Own Receptor, Regulates Growth and Amylase Synthesis in Pancreatic Acinar AR42J Cells , 1985, Diabetes.

[51]  Simon de Lusignan,et al.  Incidence, Demographics, and Clinical Characteristics of Diabetes of the Exocrine Pancreas (Type 3c): A Retrospective Cohort Study , 2017, Diabetes Care.

[52]  M. Jinzaki,et al.  Relationship between body mass index and pancreas volume in Japanese people. , 2014, JOP : Journal of the pancreas.

[53]  Y. Hiasa,et al.  Early pancreatic volume reduction on CT predicts relapse in patients with type 1 autoimmune pancreatitis treated with steroids , 2016, Orphanet Journal of Rare Diseases.

[54]  Ruma G. Singh,et al.  Pro-inflammatory cytokines after an episode of acute pancreatitis: associations with fasting gut hormone profile , 2018, Inflammation Research.

[55]  C. Dayan,et al.  Magnetic resonance imaging: a reliable method for measuring pancreatic volume in Type 1 diabetes , 2007, Diabetic medicine : a journal of the British Diabetic Association.

[56]  L. Orci,et al.  Diseases of liporegulation: new perspective on obesity and related disorders , 2001, FASEB journal : official publication of the Federation of American Societies for Experimental Biology.

[57]  Sakina H. Bharmal,et al.  Interplay between innate immunity and iron metabolism after acute pancreatitis , 2017, Cytokine.

[58]  D. Yadav,et al.  Global epidemiology and holistic prevention of pancreatitis , 2018, Nature Reviews Gastroenterology & Hepatology.

[59]  J. Fernández-Real,et al.  Insulin resistance, inflammation, and serum fatty acid composition. , 2003, Diabetes care.

[60]  Edward W. Szczepaniak,et al.  Measurement of Pancreatic Volume by Abdominal MRI: A Validation Study , 2013, PloS one.

[61]  R. Scharfmann,et al.  Structure and function of the exocrine pancreas in patients with type 1 diabetes , 2019, Reviews in Endocrine and Metabolic Disorders.