Diagnostic Value of the PEI-Q and Pancreatic Ultrasound for Identifying Reduced Pancreatic Exocrine Function in Early Type 2 Diabetes

Background/Objectives: Pancreatic symptoms and structural abnormalities do not necessarily correspond to reduced exocrine function in type 2 diabetes mellitus (T2DM). We aimed to estimate the frequency of reduced fecal elastase-1 (FE-1) and examine its associations with gastrointestinal symptom burden and pancreatic ultrasound findings.

Methods

This cross-sectional study included 251 Kazakh adults with T2DM of ≤5 years’ duration not receiving insulin therapy. FE-1 < 200 μg/g was classified as reduced. Symptoms were assessed using the Pancreatic Exocrine Insufficiency Questionnaire (PEI-Q). Model 1 included pancreatic dimensions, splenic vein diameter, and Wirsung duct dilatation; Model 2 included splenic vein diameter, duct dilatation, and PEI-Q score; Model 3 additionally adjusted for age, sex, BMI, and current smoking. Discrimination was assessed using ROC analysis, with paired DeLong comparisons and Holm adjustment.