Faculty Collaboration Database

Effect of intrapancreatic fat on diabetes outcomes after total pancreatectomy with islet autotransplantation. J Diabetes 2018 Apr;10(4):286-295

Date

08/11/2017

Pubmed ID

28796938

DOI

10.1111/1753-0407.12589

Scopus ID

2-s2.0-85031116216 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

BACKGROUND: Pancreatic fat may adversely affect β-cell mass and function, possibly via local release of non-esterified fatty acids, and proinflammatory and vasoactive factors released by adipose tissue. However, the effects of intrapancreatic fat in patients with chronic pancreatitis undergoing total pancreatectomy with islet autotransplantation (TPIAT) have not been studied. This study investigated whether pancreatic fatty infiltration has a negative effect on metabolic outcomes following TPIAT.

METHODS: The association between pancreatic fatty infiltration and diabetes outcomes was studied in 79 patients with low or high pancreatic fat content (LPF [n = 53] and HPF [n = 26], respectively) undergoing TPIAT. Pancreatic fatty infiltration was stratified using gross examinations during isolation and validated with histomorphometry of archived histology samples.

RESULTS: Fat area percentage in histology samples differed significantly between the LPF and HPF groups (2.1% ± 4.3% vs 10.6% ± 8.9%, respectively; P = 0.0009). Insulin dependence was more common in the HPF group, whereas more patients in the LPF group were insulin independent or on partial insulin supplementation at 1 year (P = 0.022). Furthermore, 1- and 2-h glucose concentrations during mixed-meal tolerance tests were significantly higher in the HPF group (P = 0.032 and 0.027, respectively) and β-scores (a composite measure of islet function and metabolic control) were significantly greater in the LPF than HPF group (6.1 ± 1.7 vs 4.6 ± 2.0; P = 0.034).

CONCLUSIONS: Patients with HPF were more likely to be insulin dependent, with higher postprandial glucose excursion, suggesting that intrapancreatic fat may lead to β-cell dysfunction with detrimental effects on diabetes outcomes after TPIAT.

Author List

Kizilgul M, Wilhelm JJ, Beilman GJ, Chinnakotla S, Dunn TB, Pruett TL, Abdulla M, Heller D, Freeman ML, Schwarzenberg SJ, Hering BJ, Bellin MD

Author

Ty Blink Dunn MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Diabetes Mellitus
Female
Humans
Hypoglycemic Agents
Insulin
Intra-Abdominal Fat
Islets of Langerhans Transplantation
Male
Middle Aged
Pancreas
Pancreatectomy
Pancreatitis, Chronic
Transplantation, Autologous
Treatment Outcome
Young Adult