An Investigation of the Relationship Between Pancreas Volume, Nutritional Status, and HbA1c in Geriatric Patients

Abstract

Background and Objectives: With physiological aging, the pancreas is expected to decrease in size as in every organ. The objective of this study was to examine the correlation between pancreas volume (PV), nutritional status, and glycolyzed hemoglobin A1c (HbA1c) in elderly patients with and without type 2 diabetes mellitus (DM). Materials and Methods: Between July 2020 and April 2022, 109 patients aged ≥ 65 years who applied to geriatrics clinics and outpatient clinics were included in the study. PV was measured from available abdominal contrast-enhanced computed tomography (CT) scans. Patients were divided into two groups according to the presence of DM. The relationship between PV; biochemical parameters, especially HbA1c; and Mini Nutritional Assessment Short Form (MNAsf) score was analyzed between groups. p < 0.05 was considered statistically significant. Results: The mean age of all participants was M: 77.40, with SD: 7.32. A total of 54.1% of the participants were female, and 55 had DM. There were no significant differences in age and gender between those with and without DM. Glucose (p < 0.001), HbA1C (p < 0.001), and triglycerides (p < 0.001) were significantly higher, and HDL (p < 0.001) was significantly lower in patients with DM. PV was also significantly lower in those with DM (p = 0.028). A correlation analysis revealed significant positive correlations between PV, the MNAsf score (rho (109)) = 0.413, p = 0.003), and lipase (rho (109)) = 0.297, p = 0.002). Conclusions: PV, which is expected to decrease with age, was found to be lower in patients with DM in our study in which we evaluated elderly patients with and without DM. We also found that PV was associated with malnutrition. Our study highlights the importance of determining the clinical effects of pancreatic volume in the geriatric population where organ atrophy is expected. Therefore, we believe that more comprehensive studies are needed to clarify the clinical implications of pancreatic volume on our diagnostic and therapeutic decisions.

Keywords: computed tomography imaging; diabetes; elderly; malnutrition; pancreas volume.

Figure 1

Patient selection flowchart.

Figure 2

Calculations of the pancreatic volume on CT images. (a) The CT scans were transferred to workstations manufactured by GE in the USA, model AW Volume Share 7. Using manually controlled cursors, radiologists outlined the outer boundary of the pancreas during the parenchymal phase on axial images. Fatty tissue and vascular structures, such as the splenic artery and the portal vein, were excluded to the greatest extent possible. (b) The total volume of the pancreas was calculated using customized three-dimensional volumetric software (AW4.7 Ext.13 Software, GE, Chicago, IL, USA) on workstations within the designated area.

Figure 3

Distribution of pancreas volume between groups.