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However, its mechanism is unclear, with no established noninvasive imaging method for the evaluation of its pathogeneses. The present study focused on pancreas stiffness, as assessed by shear wave elastography (SWE), and examined its association with portal hypertension and insulin secretion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Shear wave elastography and contrast\u2010enhanced ultrasonography were utilized to evaluate pancreas stiffness and congestion, respectively. A glucagon challenge test was used for insulin secretion assessment. Furthermore, rat models of carbon tetrachloride (CCl<jats:sub>4<\/jats:sub>)\u2010induced LC and portal hypertension were used to identify the direct effects of pancreatic congestion. Immunohistochemistry staining of the pancreas was carried out on human autopsy samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pancreas stiffness measured by SWE was higher in patients with LC than in controls and showed significant correlation with pancreatic congestion. The glucagon challenge test indicated a lower value for the change in C\u2010peptide immunoreactivity in the LC group, which was inversely correlated with pancreas stiffness and congestion. Additionally, portal hypertension and insulin secretion dysfunction were confirmed in CCl<jats:sub>4<\/jats:sub> rat models. Autopsy of human samples revealed congestive and fibrotic changes in the pancreas and the relationship between insulin secretion and their factors in patients with LC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with LC, pancreas stiffness measured by SWE could be a potential noninvasive test for evaluating pancreatic congestion and fibrosis due to portal hypertension. Moreover, it was associated with impaired insulin secretion, and could aid in guiding the treatment for hepatogenous diabetes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.13672","type":"journal-article","created":{"date-parts":[[2021,5,21]],"date-time":"2021-05-21T00:05:23Z","timestamp":1621555523000},"page":"775-785","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Pancreas stiffness in liver cirrhosis is an indicator of insulin secretion caused by portal hypertension and pancreatic congestion"],"prefix":"10.1111","volume":"51","author":[{"given":"Yoshiki","family":"Imamura","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine  Ehime Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teru","family":"Kumagi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Metabology Ehime 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