New technology provides means for measuring pancreatic fat, determining diabetes risk

Researchers at the University of Texas Southwestern Medical Center have performed the first ever noninvasive procedure measuring pancreatic fat with magnetic resonance spectroscopy. Data suggest that this may serve as an effective way to identify people at high risk for diabetes.

“These are very early results, but if they hold true, pancreatic magnetic resonance spectroscopy would be a fast and noninvasive test to screen people at risk for diabetes either because they’re obese or they have a family history of type 2 diabetes or metabolic syndrome,” Ildiko Lingvay, MD, assistant professor of internal medicine at the center, said in a press release. “It could potentially tell physicians which patients are most likely to develop diabetes in the near future and thus are in need of more aggressive interventions.”

Lingvay and colleagues measured pancreatic triglyceride content with magnetic resonance spectroscopy in 79 participants. The researchers also obtained duplicate magnetic resonance spectroscopy measurements one to two weeks apart to assess the reproducibility of the method in 33 volunteers. Participants were separated into four groups based on BMI and glucose tolerance.

Researchers found that volunteers who were overweight and obese had significantly more pancreatic fat when compared with those in the lean group. More pancreatic fat was found among participants who had similar BMI but had already developed either prediabetes or diabetes. Human pancreatic steatosis increased with BMI and impaired glycemia.

Magnetic resonance spectroscopy quantified triglyceride content and demonstrated high reproducibility and concordance to the biochemical measurement (Spearman’s rank correlation coefficient = 0.91), according to an abstract.

Lingvay noted that magnetic resonance spectroscopy has not been approved for routine clinical use but said the “technology represents a good opportunity for clinicians to pursue research that hasn’t been possible because of the lack of advanced tools.”

Lingvay I. J Clin Endocrinol Metab. 2009; doi:10.1210/jc.2009-0584.

Accurate identification of individuals destined to develop type 2 diabetes is very important, not only to assure that they get risk counseling and targeted lifestyle intervention coaching so as to minimize the expression of the disease, but also to allow intervention with other therapies as they become available. It's known that not all fat is created equal where diabetes risk is concerned; that is, visceral compartment adiposity imposes much more risk than does subcutaneous fat. From this new study, intrapancreatic fat looks to be particularly predictive of type 2 diabetes. Further studies should examine the value of this MRS application.

– Stephen A. Brietzke, MD, FACP, FACE

Endocrine Today Editorial Board member