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Pancreatic Fat Content and ß-cell Function in Men With and Without Type 2 Diabetes

¹Department of Endocrinology/Diabetes Center
²Department of Physics & Medical Technology
³Department of Radiology; VU University Medical Center, Amsterdam, The Netherlands
⁴Institute of Biomedical Engineering, National Research Council, Padova, Italy

m.diamant{at}vumc.nl

ABSTRACT

Objective:Insulin resistance, associated with increased lipolysis, results in a high exposure of non-adipose tissues to lipids. Experimental data indicate that fatty infiltration of pancreatic islets may also contribute to ß-cell dysfunction, but whether this occurs in humans in vivo is unknown.

Research Design and Methods:Using proton magnetic resonance spectroscopy and oral glucose tolerance tests, we studied the association of pancreatic lipid accumulation in vivo and various aspects of ß-cell function in 12 insulin-naïve type 2 diabetic and 24 age- and BMI-matched non-diabetic males.

Results:Patients versus controls had higher HbA1c, fasting plasma glucose, insulin and triglyceride levels, lower HDL-C, but similar waist circumference. Median (interquartile range) pancreatic fat content in patients and controls was 20.4 (13.4-43.6) and 9.7 (7.0-20.2)%, respectively (P=0.032). Pancreatic fat correlated negatively with ß-cell function parameters, including the insulinogenic index adjusted for insulin resistance, early glucose-stimulated insulin secretion, ß-cell glucose sensitivity, rate sensitivity (all P<0.05), but not potentiation. However, these associations were significantly affected by the diabetic state, such that a significant association of pancreatic fat with ß-cell dysfunction was only present in the non-diabetic group (all P<0.01), suggesting that once diabetes occurs, factors additional to pancreatic fat account for further ß-cell function decline. In controls, the association of pancreatic fat and ß-cell function remained significant after correction for BMI, fasting plasma glucose and triglycerides (P=0.006).

Conclusions:These findings indicate that pancreatic lipid content may contribute to ß-cell dysfunction and possibly to the subsequent development of type 2 diabetes in susceptible humans.

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				M. E. Tushuizen, M. C. Bunck, P. J. Pouwels, and M. Diamant Pancreatic Fat Content and {beta}-Cell Function in Men With and Without Type 2 Diabetes: Response to Saisho, Butler, and Butler Diabetes Care, May 1, 2008; 31(5): e39 - e39. [Full Text] [PDF]