Pancreatic size and fat content in diabetes: A systematic review and meta-analysis of imaging studies

PLoS One. 2017 Jul 24;12(7):e0180911. doi: 10.1371/journal.pone.0180911. eCollection 2017.


Objectives: Imaging studies are expected to produce reliable information regarding the size and fat content of the pancreas. However, the available studies have produced inconclusive results. The aim of this study was to perform a systematic review and meta-analysis of imaging studies assessing pancreas size and fat content in patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM).

Methods: Medline and Embase databases were performed. Studies evaluating pancreatic size (diameter, area or volume) and/or fat content by ultrasound, computed tomography, or magnetic resonance imaging in patients with T1DM and/or T2DM as compared to healthy controls were selected. Seventeen studies including 3,403 subjects (284 T1DM patients, 1,139 T2DM patients, and 1,980 control subjects) were selected for meta-analyses. Pancreas diameter, area, volume, density, and fat percentage were evaluated.

Results: Pancreatic volume was reduced in T1DM and T2DM vs. controls (T1DM vs. controls: -38.72 cm3, 95%CI: -52.25 to -25.19, I2 = 70.2%, p for heterogeneity = 0.018; and T2DM vs. controls: -12.18 cm3, 95%CI: -19.1 to -5.25, I2 = 79.3%, p for heterogeneity = 0.001). Fat content was higher in T2DM vs. controls (+2.73%, 95%CI 0.55 to 4.91, I2 = 82.0%, p for heterogeneity<0.001).

Conclusions: Individuals with T1DM and T2DM have reduced pancreas size in comparison with control subjects. Patients with T2DM have increased pancreatic fat content.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adipose Tissue / diagnostic imaging
  • Adipose Tissue / pathology
  • Diabetes Mellitus, Type 1 / diagnostic imaging*
  • Diabetes Mellitus, Type 1 / pathology
  • Diabetes Mellitus, Type 2 / diagnostic imaging*
  • Diabetes Mellitus, Type 2 / pathology
  • Humans
  • Observational Studies as Topic
  • Organ Size
  • Pancreas / diagnostic imaging*
  • Pancreas / pathology

Grant support

This work was supported by Fundo de Incentivo à Pesquisa e Ensino do Hospital de Clínicas de Porto Alegre. CBL receives a scholarship from Conselho de Nacional de Desenvolvimento Científico e Tecnológico (CNPq).