Pancreatic Stiffness in Patients with Type 2 Diabetes Mellitus Assessed by 2-Dimensional Shear Wave Elastography: A Pilot Case-Control Study.

BACKGROUND/AIMS: Shear wave elastography (SWE) is a noninvasive method for assessing tissue stiffness. This study evaluated pancreatic stiffness in patients with type 2 diabetes mellitus (T2DM) and examined its association with metabolic factors and microvascular complications. MATERIALS AND METHODS: This prospective case-control study included 45 patients with T2DM and 45 healthy controls. Pancreatic stiffness was measured using 2-dimensional SWE (2D-SWE). Clinical, anthropometric, and laboratory data were collected, and diabetic microvascular complications were assessed. RESULTS: A total of 90 participants were included, comprising 45 patients with T2DM and 45 healthy controls. Pancreatic stiffness was significantly higher in patients with T2DM than in controls across all pancreatic regions (P < .001). However, pancreatic stiffness did not differ significantly between patients with T2DM with and without microvascular complications (P > .05). Pancreatic steatosis (PS) was more prevalent in patients with T2DM than in healthy controls (P = .001). Among patients with T2DM, pancreatic stiffness was significantly higher in those with steatosis than in those without (P = .035), and stiffness increased with the severity of steatosis (P = .021). Body mass index and waist circumference (WC) were independently associated with increased pancreatic stiffness, with WC accounting for a significant proportion of the variance (P < .001). CONCLUSION: Pancreatic stiffness was significantly higher in patients with T2DM than in healthy controls and was primarily associated with metabolic factors, particularly obesity and PS, rather than microvascular complications. These findings suggest that increased pancreatic stiffness may reflect metabolic associated pancreatic alterations.