CT imaging shows specific pancreatic abnormalities in persons with cystic fibrosis related diabetes

• Published in: Scientific reports Vol. 13; no. 1; pp. 10433 - 8
• Main Authors: Alexandre-Heymann, Laure, Puerto, Marie, Martin, Clémence, Burnet, Espérie, Mosnier-Pudar, Helen, Burgel, Pierre-Régis, Larger, Etienne
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 27.06.2023; Nature Publishing Group; Nature Portfolio
• Subjects: 692/163; 692/1807; 692/308; 692/698; Computed tomography; Cystic fibrosis; Diabetes; Diabetes mellitus; Humanities and Social Sciences; Lipomatosis; multidisciplinary; Pancreas; Science; Science (multidisciplinary)
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-023-37492-4

Cystic fibrosis related diabetes (CFRD) is observed in 20–50% of adults with cystic fibrosis (CF). Pancreas abnormalities on imaging, e.g. pancreas lipomatosis, are frequent in subjects with CF. We hypothesized that specific abnormalities may characterize patients with CFRD. We performed a retrospective study comparing the computed tomography (CT) of participants with CF with or without diabetes (“CFRD” and “CF control” groups). We classified the pancreas on imaging according to 3 categories: normal, partial lipomatosis and complete lipomatosis of the pancreas. We also assessed the presence or absence of pancreatic calcifications. Forty-one CFRD and 53 CF control participants were included. Only 2% of the patients with CFRD had a normal pancreas, as compared with 30% of the participants from the CF control group ( p  = 0.0016). Lipomatosis was more frequent in subjects with CFRD and was related to exocrine pancreatic insufficiency (EPI) and to severe CFTR mutations (classes I to III). Nine participants with diabetes (22%) presented with pancreatic calcifications, versus none of the control participants ( p  = 0.0003). In conclusion, pancreas imaging was almost always abnormal in subjects with CFRD, while it was normal in a third of the CF control subjects. Pancreatic calcifications were specific of subjects with CFRD.