Dataset Information

Morphology of the pancreas in type 2 diabetes: effect of weight loss with or without normalisation of insulin secretory capacity.

ABSTRACT:

Aims/hypothesis

This study was designed to establish whether the low volume and irregular border of the pancreas in type 2 diabetes would be normalised after reversal of diabetes.

Methods

A total of 29 individuals with type 2 diabetes undertook a very low energy (very low calorie) diet for 8 weeks followed by weight maintenance for 6 months. Methods were established to quantify the pancreas volume and degree of irregularity of the pancreas border. Three-dimensional volume-rendering and fractal dimension (FD) analysis of the MRI-acquired images were employed, as was three-point Dixon imaging to quantify the fat content.

Results

There was no change in pancreas volume 6 months after reversal of diabetes compared with baseline (52.0?±?4.9 cm(3) and 51.4?±?4.5 cm(3), respectively; p?=?0.69), nor was any volumetric change observed in the non-responders. There was an inverse relationship between the volume and fat content of the pancreas in the total study population (r?=-0.50, p?=?0.006). Reversal of diabetes was associated with an increase in irregularity of the pancreas borders between baseline and 8 weeks (FD 1.143?±?0.013 and 1.169?±?0.006, respectively; p?=?0.05), followed by a decrease at 6 months (1.130?±?0.012, p?=?0.006). On the other hand, no changes in FD were seen in the non-reversed group.

Conclusions/interpretation

Restoration of normal insulin secretion did not increase the subnormal pancreas volume over 6 months in the study population. A significant change in irregularity of the pancreas borders occurred after acute weight loss only after reversal of diabetes. Pancreas morphology in type 2 diabetes may be prognostically important, and its relationship to change in beta cell function requires further study.

SUBMITTER: Al-Mrabeh A

PROVIDER: S-EPMC4930466 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature

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Publications

Morphology of the pancreas in type 2 diabetes: effect of weight loss with or without normalisation of insulin secretory capacity.

Al-Mrabeh Ahmad A Hollingsworth Kieren G KG Steven Sarah S Taylor Roy R

Diabetologia 20160514 8

<h4>Aims/hypothesis</h4>This study was designed to establish whether the low volume and irregular border of the pancreas in type 2 diabetes would be normalised after reversal of diabetes.<h4>Methods</h4>A total of 29 individuals with type 2 diabetes undertook a very low energy (very low calorie) diet for 8 weeks followed by weight maintenance for 6 months. Methods were established to quantify the pancreas volume and degree of irregularity of the pancreas border. Three-dimensional volume-renderin ...[more]

PMID: 27179658

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Project description:ObjectiveAlthough impairment in pancreatic insulin secretion is known to precede the clinical diagnosis of type 2 diabetes by up to a decade, fasting blood glucose concentration only rises abnormally once the impairment reaches a critical threshold. Despite its centrality to the pathogenesis of type 2 diabetes, the pancreas is the least studied organ due to its inaccessible anatomical position. Previous ultrasound and CT studies have suggested a possible decrease in pancreatic volume in type 2 diabetes. However, ultrasound techniques are relatively insensitive while CT uses ionizing radiation, making these modalities unsuitable for precise, longitudinal studies designed to explore the underlying mechanisms of type 2 diabetes. Hence there is a need to develop a non-invasive, safe and precise method to quantitate pancreas volume.MethodsWe developed and applied magnetic resonance imaging at 3.0T to obtain balanced turbo field echo (BTFE) structural images of the pancreas, together with 3-point Dixon images to quantify pancreatic triglyceride content. Pancreas volume, morphology and triglyceride content was quantified in a group of 41 subjects with well-controlled type 2 diabetes (HbA1c ? 7.6%) taking only metformin (duration of T2DM 5.7 ± 0.7 years), and a control group of 14 normal glucose tolerance subjects matched for age, weight and sex.ResultsThe mean pancreatic volume was found to be 33% less in type 2 diabetes than in normal glucose tolerant subjects (55.5 ± 2.8 vs. 82.6 ± 4.8 cm3; p < 0.0001). Pancreas volume was positively correlated with HOMA-? in the type 2 diabetes subjects (r = 0.31; p = 0.03) and controls (r = 0.46; p = 0.05) considered separately; and in the whole population studied (r = 0.37; p = 0.003). In type 2 diabetes, the pancreas was typically involuted with a serrated border. Pancreatic triglyceride content was 23% greater (5.4 ± 0.3 vs. 4.4 ± 0.4%; p = 0.02) in the type 2 diabetes group.ConclusionThis study describes for the first time gross abnormalities of the pancreas in early type 2 diabetes and quantifies the decrease in pancreas size, the irregular morphology and increase in fat content.

Dataset Information

Morphology of the pancreas in type 2 diabetes: effect of weight loss with or without normalisation of insulin secretory capacity.

Aims/hypothesis

Methods

Results

Conclusions/interpretation

Publications

Morphology of the pancreas in type 2 diabetes: effect of weight loss with or without normalisation of insulin secretory capacity.

Similar Datasets

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