{
  "abstract": "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. Results: Reduced FE-1 was identified in 59 participants (23.5%) and was associated with higher PEI-Q scores, smaller pancreatic dimensions, and more frequent Wirsung duct dilatation. In Model 3, duct dilatation (adjusted OR 5.388, 95% CI 2.346–12.376) and PEI-Q score (adjusted OR 2.089, 95% CI 1.043–4.187) were independently associated with reduced FE-1. PEI-Q alone showed limited discrimination (AUC 0.583); AUCs for Models 1, 2, and 3 were 0.771, 0.697, and 0.726, respectively. Model 2 did not significantly outperform Model 1, and Model 3 did not significantly outperform Model 2. Conclusions: Reduced FE-1 was identified in 23.5% of participants and was associated with symptom burden and selected ultrasound findings. PEI-Q alone showed limited discrimination, whereas models incorporating ultrasound variables showed higher AUCs. Neither PEI-Q nor pancreatic ultrasound can replace FE-1 measurement; external validation is required before clinical application.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Internal Diseases No 1, West Kazakhstan Marat Ospanov Medical University, Aktobe 030000, Kazakhstan",
    "Administrative and Management Personnel (AMP), West Kazakhstan Marat Ospanov Medical University, Aktobe 030000, Kazakhstan",
    "Department of Endocrinology, Nicolae Testemitanu State University of Medicine and Pharmacy, MD-2012 Chisinau, Moldova"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yerlan Bazargaliyev",
      "orcid": "0000-0002-4350-3455"
    },
    {
      "affs": [
        1
      ],
      "name": "Talgar Abilov"
    },
    {
      "affs": [
        0
      ],
      "name": "Mengtay Makashova",
      "orcid": "0000-0003-0486-9187"
    },
    {
      "affs": [
        0
      ],
      "name": "Khatimya Kudabayeva"
    },
    {
      "affs": [
        2
      ],
      "name": "Lorina Vudu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9yz00bsx26n3w.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15208157",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705915/?tool=EBI",
  "id": "9yz00bsx26n3w",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/20/8157",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Pancreatitis Pathology and Treatment"
    ]
  ],
  "openalex": "W7223039288",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705915/pdf/?tool=EBI",
  "pmcid": "PMC13705915",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/9yz00bsx26n3w.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:01Z",
      "native_id": "10.3390/jcm15208157",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/8157"
    },
    {
      "first_seen": "2026-10-30T12:21:25Z",
      "native_id": "PMC:PMC13705915",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13705915"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Pancreatitis Pathology and Treatment",
      "subfield": "surgery"
    }
  ],
  "title": "Diagnostic Value of the PEI-Q and Pancreatic Ultrasound for Identifying Reduced Pancreatic Exocrine Function in Early Type 2 Diabetes",
  "title_text": "Diagnostic Value of the PEI-Q and Pancreatic Ultrasound for Identifying Reduced Pancreatic Exocrine Function in Early Type 2 Diabetes",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:25Z",
  "url": "https://research.draconitic.com/paper/9yz00bsx26n3w",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}