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Association of Pancreas Volume With Adverse Clinical Outcomes
Philip Thomas1, Celestin Missikpode1, Omar Garcia Martinez1
1Division of Nephrology, Department of Medicine University of Illinois Chicago Chicago IL USA.
Insights
Smaller pancreas volume (PV) is linked to higher risks of cardiovascular disease (CVD) and death. This study in UK Biobank participants highlights PV as a potential indicator for adverse health outcomes.
Area of Science:
- Medical Imaging
- Cardiovascular Health
- Endocrinology
Background:
- Chronic diseases can damage the pancreas, reducing pancreas volume (PV).
- The impact of reduced PV on adverse clinical outcomes is not well understood.
- Pancreatic function is crucial for endocrine and exocrine processes.
Purpose of the Study:
- To investigate the association between predicted pancreas volume (pPV) and risks of incident chronic kidney disease, cardiovascular disease (CVD), and death.
- To determine if individuals with smaller pPV have a higher risk of adverse health events.
Main Methods:
- Estimated baseline age-adjusted predicted pancreas volume (pPV) using abdominal MRI in 36,592 UK Biobank participants.
- Calculated pPV slope using repeat MRI scans from 451 participants to model PV change over time.
- Utilized multivariable-adjusted proportional hazards models to assess associations between pPV and incident chronic kidney disease, CVD, and death.
Main Results:
- Lower pPV quartiles were associated with significantly increased risks of incident CVD (1.67-fold) and death (1.28-fold).
- Nonlinear associations were observed between pPV and incident CVD and death (P<0.001).
- No significant association was found between pPV and incident chronic kidney disease.
Conclusions:
- Reduced pancreas volume (pPV) is associated with an elevated risk of cardiovascular disease and mortality.
- Pancreas volume may serve as a prognostic biomarker for cardiovascular events and death.
- Further research is needed to elucidate the underlying pathophysiological mechanisms linking pPV to adverse outcomes.
Background:
Chronic diseases may injure the pancreas and result in a reduction in pancreas volume (PV), which may adversely impact its critical role in endocrine and exocrine function. Less is known about whether individuals with smaller PV face higher risks of adverse clinical outcomes.
Methods:
We estimated baseline age-adjusted predicted PV (pPV) from abdominal magnetic resonance imaging in 36 592 UK Biobank participants. Since the initial magnetic resonance imaging occurred 9.0 (interquartile range, 7.5-10.1) years after baseline, we fit a linear regression equation that included age for the outcome of PV slope in 451 participants with repeat magnetic resonance imaging 2.8 (interquartile range, 2.2-4.8) years after the initial scan. Using these data, we calculated baseline age-adjusted pPV slope by adding or subtracting the annual change to the initial PV measurement assuming linear change in PV over time. Multivariable-adjusted proportional hazards models tested associations of pPV with incident chronic kidney disease, cardiovascular disease (CVD; myocardial infarction, heart failure, or stroke), and death.
Results:
Participants (52.2% women) were 55±8 years old and had a pPV of 63.3±15.3 mL. During median follow-up of 13.9 years, there were 757 incident chronic kidney disease, 1392 CVD, and 702 death events. In final adjusted models, participants in the first pPV quartile had a 1.67-fold (95% CI, 1.34-2.07) and 1.28-fold (95% CI, 1.10-1.49) increased risk of incident CVD and death compared with the fourth quartile, respectively. pPV had nonlinear associations with incident CVD and death (each P<0.001). pPV was not associated with incident chronic kidney disease.
Conclusions:
Lower pPV is associated with increased risk of incident CVD and death but not incident chronic kidney disease. Future studies should investigate the pathophysiologic mechanisms driving these associations.
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