American Diabetes Association
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Longitudinal Assessment of Pancreas Volume by MRI Predicts Progression to Stage 3 Type 1 Diabetes

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posted on 2023-12-28, 03:12 authored by John Virostko, Jordan J Wright, Jonathan M Williams, Melissa A Hilmes, Taylor M Triolo, Hali Broncucia, Liping Du, Hakmook Kang, Shreya Nallaparaju, Leah Galvez Valencia, Demetra Reyes, Brenna Hammel, William E Russell, Louis H Philipson, Michaela Waibel, Thomas W H Kay, Helen E Thomas, Siri Atma W Greeley, Andrea K Steck, Alvin C Powers, Daniel J Moore

Objective This multicenter prospective cohort study compared pancreas volume as assessed by MRI, metabolic scores derived from oral glucose tolerance testing (OGTT), and a combination of pancreas volume and metabolic scores for predicting progression to Stage 3 type 1 diabetes (T1D) in individuals with multiple diabetes-related autoantibodies. Research Design and Methods Pancreas MRI were performed in 65 multiple autoantibody-positive participants enrolled in the Type 1 Diabetes TrialNet Pathway to Prevention study. Prediction of progression to Stage 3 T1D was assessed using pancreas volume index, OGTT-derived Index60 and Diabetes Prevention Trial-Type 1 Risk Score (DPTRS) scores, as well as a combination of pancreas volume index and DPTRS. Results Pancreas volume index, Index60, and DPTRS were all significantly different at study entry in 11 individuals who subsequently progressed to Stage 3 T1D compared with 54 participants who did not progress (p < 0.005). Pancreas volume indexdid not correlate with metabolic testing across individual study participants. Pancreas volume index declined longitudinally in the 11 individuals diagnosed with Stage 3 T1D, while Index60 and DPTRS increased. The area under the receiver operating curve for predicting progression to Stage 3 from measurements at study entry was 0.76 for pancreas volume index, 0.79 for Index60, 0.79 for DPTRS, and 0.91 for pancreas volume index and DPTRS. Conclusions These findings suggest that measures of pancreas volume and metabolism reflect distinct components of risk for developing Stage 3 type 1 diabetes and that combining these measures may provide superior prediction than either alone.


We gratefully acknowledge research support from The Leona M. and Harry B. Helmsley Charitable Trust (2207-05374), JDRF International (3-SRA-2015-102-M-B and 3-SRA-2019-759-M-B), the NIDDK (R03DK129979), the JP Fletcher Foundation, and the Thomas J. Beatson, Jr. Foundation (2021-003). We also acknowledge funding by grant U24DK097771 via the NIDDK Information Network’s (dkNET) New Investigator Pilot Program in Bioinformatics. This work utilized REDCap and VCTRS resources which are supported by UL1 TR000445 from NCATS/NIH. We also acknowledge support from the Vanderbilt Diabetes Research & Training Center (DK-020593) and the VUIIS Center for Human Imaging (1 S10OD021771 01). This study was performed under the auspices of the Multicenter Assessment of the Pancreas in Type 1 Diabetes international consortium (MAP-type 1 diabetes; The Type 1 Diabetes TrialNet Study Group is a clinical trials network funded through a cooperative agreement by the National Institutes of Health (NIH) through the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the National Institute of Allergy and Infectious Diseases (NIAID), and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and JDRF. The study sponsors were not involved in the design of the study, the collection, analysis, and interpretation of data, writing the report, and did not impose any restrictions regarding the publication of the report.


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