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Slide database suitable for quantifying beta-cell mass in Ab+ nondiabetics
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The insulin-stained virtual slides of the Network of Pancreatic Organ Donors with Diabetes project, which are currently publicly available, are appropriate for use in the quantification of beta-cell mass in patients without diabetes, according to recent findings.
Etienne Larger, MD, PhD, of the service de diabétologie at Cochin Hospital, Paris, France, and colleagues accessed the nPOD database and downloaded all insulin-stained slides available as of July 2013 from nondiabetic, antibody-negative (Ab-) organ donors (n = 69; 415 slides). These subjects had normal HbA1c and no IA-2 or GAD antibodies (Abs). The researchers also downloaded insulin-stained slides of antibody-positive (Ab+) nondiabetic subjects (n = 18; 101 slides) as well as from patients with recent-onset type 1 diabetes (n = 8; 46 slides). Of these subjects, 48 Ab-, 15 Ab+ and 7 recent-onset type 1 diabetes individuals had pancreatic mass data available, which were used to quantify beta-cell mass.
Etienne Larger
The researchers found that in the 48 Ab- subjects for whom pancreatic weight was available, mean beta-cell mass was 0.66 ± 0.42 g and endocrine mass 1.0 ± 0.65 g.
The proportion of exocrine tissue relative to tissue area was negatively correlated with BMI (r = -0.35, P = .005) and age (r = -0.40; P < .001). In an analysis of non-exocrine fraction by age group, the percentage of non-exocrine tissue was 24% and consistent from birth to age 50, and then increased to 47% after age 60. The non-exocrine fraction was 32% higher in the head (33%) vs. the tail (25%) of the pancreas (P < .0001). The proportion of beta-cell area in relation to total pancreatic area was higher in the tail (0.83%) vs. the head (0.71%; P < .001). The beta-cell mass and beta-cell areas were similar between Ab+ and Ab- negative subjects, while these measures were significantly lower in subjects with recent-onset disease.
“There are three important results of the study,” Larger told Endocrine Today. “The nPOD is a big success as it allowed us to answer questions regarding the pathology of the pancreas in humans, without additional need, (i.e., the publicly available slides were perfectly suited for asking pertinent questions); the distribution of islets is similar between the head and the tail of the pancreas; and subjects with one or two diabetes-associated antibodies and (still) normal glucose control showed normal beta-cell mass. Thus antibody positivity does not necessarily mean ongoing beta-cell destruction.” – by Jennifer Byrne
Disclosure: The researchers report no relevant financial disclosures.
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