II Reduced Pancreatic Volume in Hepatocyte Nuclear Factor 1A-Maturity-Onset Diabetes of the Young

Context: There are interplays between the endocrine and exocrine pancreas.We recently reported an increased frequency of exocrine dysfunction in HNF1A-maturity-onset diabetes of the young (MODY3) patients, compared with controls. Reduced pancreatic volume is seen in HNF1B-MODY (MODY5) and diabetes types 1 and 2. Objective: The aimof this studywas to investigatewhetherHNF1Amutation carriers have reduced pancreatic volume or abnormal pancreatic structure andwhether any changes are associatedwith exocrine dysfunction. Methods: Fifteen HNF1A mutation carriers recruited from the Norwegian MODY Registry, 31 subjects with type 1 diabetes, 10 subjects with type 2 diabetes, and 11 controls underwent com-puted tomography of the pancreas. We measured pancreatic volume and X-ray attenuation. Pan-creatic volume index was defined as pancreatic volume divided by body surface area. Results: Pancreatic volume indexwas reduced in subjectswithHNF1A-MODY (34.5ml/m2; P 0.02) and type 1 diabetes (21.4 ml/m2; P 0.001) as compared with nondiabetic controls (45.7 ml/m2), andwas reduced in subjects with diabetes in combinationwith fecal elastase deficiency (P 0.03). Subjects with type 1 diabetes had smaller pancreatic volume index, compared with HNF1A muta