# Association Between Pancreatic Cysts and Diabetes Mellitus in Von Hippel-Lindau Disease

## TL;DR

This study found that people with VHL disease and large pancreatic cysts are more likely to have diabetes or high blood sugar levels.

## Contribution

The study is the first to show a link between pancreatic cyst size and diabetes in VHL patients.

## Key findings

- Patients with diabetes or high HbA1c had significantly larger pancreatic cyst areas.
- The percentage of pancreatic cysts was higher in patients with diabetes or high HbA1c.
- No significant difference was found in the total pancreas area between the groups.

## Abstract

Introduction: Pancreatic cysts are frequently observed in patients with von Hippel-Lindau disease (VHL), and they are considered clinically not important. This study aimed to evaluate the association between pancreatic cysts and diabetes mellitus (DM) in patients with VHL.

Methods: Among patients who were on a patient list at the VHL Center at Kyoto University Hospital as of December 2022, those who had undergone an upper abdominal magnetic resonance imaging study after 2010 were retrospectively evaluated. The presence or absence of DM and high glycated hemoglobin (HbA1c) levels (>6.0%) were assessed. Patients were divided into two groups: those with DM or high HbA1c levels, and those without DM or high HbA1c levels. The area of the whole pancreas, including the pancreatic cysts and tumors, the area of the pancreatic cysts, and the percentage of pancreatic cysts, calculated by dividing the area of pancreatic cysts by the area of the whole pancreas, were measured on T2-weighted magnetic resonance images and compared between the two groups.

Results: Thirty-six patients with VHL, comprising 22 men and 14 women, with a mean age of 36.4 years (range, 11-79 years), were identified. Seven patients had DM, and two additional patients had high HbA1c levels. The area of the pancreatic cysts (p = 0.0013) was significantly larger and the percentage of the pancreatic cysts (p = 0.0016) was significantly higher in patients with DM or high HbA1c levels (n = 9) than in patients without DM or high HbA1c levels (n = 27); however, the difference in the area of the whole pancreas was not significant (p = 0.068).

Conclusion: Our findings suggest that patients with VHL who have a large area covered by pancreatic cysts are more likely to have DM than those without.