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. 2020 Jan;11(1):80-87.
doi: 10.1111/jdi.13108. Epub 2019 Jul 27.

Pancreatic fat is related to the longitudinal decrease in the increment of C-peptide in glucagon stimulation test in type 2 diabetes patients

Chisaki Ishibashi  1 , Junji Kozawa  1 , Yoshiya Hosakawa  1 , Sho Yoneda  1 , Takekazu Kimura  1 , Yukari Fujita  1   2 , Kenji Fukui  1 , Hiromi Iwahashi  1   3 , Iichiro Shimomura  1
Affiliations

Pancreatic fat is related to the longitudinal decrease in the increment of C-peptide in glucagon stimulation test in type 2 diabetes patients

Chisaki Ishibashi et al. J Diabetes Investig. 2020 Jan.

Abstract

Aims/introduction: The relationship between pancreatic fatty infiltration and diabetes is widely known, whereas the causal relationship is not clear. Furthermore, it is uncertain whether pathogenesis of pancreatic fat is similar to that of liver fat. We aimed to clarify the contribution of this type of fat to glucose metabolism in type 2 diabetes patients by cross-sectional and longitudinal analyses.

Material and methods: A total of 56 patients with type 2 diabetes who had been hospitalized twice were analyzed. We evaluated the mean computed tomography values of the pancreas (P), liver (L) and spleen (S). Lower computed tomography values indicate a greater fat content. We defined indices of pancreatic or liver fat content as the differences between P or L and S. We assessed the associations among fat content for the two organs (P-S, L-S) and clinical parameters at the first hospitalization, and then analyzed the associations between these fat contents and changes in glycometabolic markers (the second data values minus the first).

Results: In the cross-sectional study, P-S negatively correlated with the increment of C-peptide in the glucagon stimulation test (r = -0.71, P < 0.0001) and body mass index (r = -0.28, P = 0.034). L-S negatively correlated with homeostasis model assessment of insulin resistance (r = -0.73, P < 0.0001), body mass index (r = -0.62, P < 0.0001) and some other obesity-related indicators, but not with the increment of C-peptide in the glucagon stimulation test. In the longitudinal study, P-S positively correlated with the change of the increment of C-peptide in the glucagon stimulation test (r = 0.49, P = 0.021).

Conclusions: In type 2 diabetes patients, pancreatic fat was less associated with obesity-related indicators than liver fat, but was more strongly associated with the longitudinal decrease in endogenous insulin-secreting capacity.

Keywords: Insulin secretion capacity; Pancreatic fat; Type 2 diabetes.

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Figures

Figure 1
Figure 1
Flowchart for the recruitment of the patients.
Figure 2
Figure 2
Correlation analysis for P‐S (an index of pancreatic fat content) and L‐S (an index of liver fat content). There was no significant correlation between them.
Figure 3
Figure 3
Correlation analysis of ⊿CPR (increment of C‐peptide in the glucagon stimulation test) and P‐S (an index of pancreatic fat content). The result indicated that individuals with a greater capacity for insulin secretion tended to have more severe fatty infiltration of the pancreas.
Figure 4
Figure 4
Correlation analysis of P‐S (an index of pancreatic fat content) and ⊿(⊿CPR) (the change in ⊿CPR evaluated in two hospitalizations). The result indicates more severe fatty infiltration of the pancreas is likely to lead to a greater subsequent decrease in ⊿CPR.
See this image and copyright information in PMC

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