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Beta-cell mass fails to increase in response to insulin resistance among Japanese
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In Japanese patients, any increase in beta-cell mass is limited during insulin resistance, suggesting that beta-cell mass — and not alpha-cell mass — plays a major role in regulating blood glucose levels in humans.
Yoshifumi Saisho, MD, PhD, assistant professor at Keio University School of Medicine in Japan, and colleagues evaluated 99 Japanese patients (49 with type 2 diabetes) who underwent pancreatic surgery and had a resected pancreatic sample that contained adequate normal pancreas for histological study. Researchers sought to evaluate the effects of diabetes and obesity on beta- and alpha-cell mass.
Compared with the group without diabetes, the diabetes group had a 46% decrease in beta-cell area (P < .001); however, no difference was observed in alpha-cell mass between the groups. Compared with the group without diabetes, the diabetes group had an increased ratio of alpha-cell area to beta-cell area (P = .045).
For both groups, no differences were found between lean participants and those with obesity for beta-cell area, alpha-cell area or the ratio of alpha-cell area to beta-cell area.
Researchers found a negative relationship between beta-cell area and HbA1c (P < .001) and glycated albumin (P = .003). After adjustment for age, sex, BMI and presence of pancreatic cancer, the relationship between beta-cell area and HbA1c remained significant (P = .04). Before surgery, beta-cell area was linked to the ratio of serum C-peptide immunoreactivity to plasma glucose (P = .005).
“There was no increase in [beta-cell mass] in Japanese obese individuals who underwent pancreatic surgery, and [beta-cell mass] was not related to BMI, history of obesity or maximum BMI,” the researchers wrote. “These findings suggest that the increase in [beta-cell mass] in the face of insulin resistance is extremely limited in Japanese. [Beta-cell mass] was reduced by [approximately] 45% in patients with [type 2 diabetes], and [beta-cell mass], but not [alpha-cell mass], was associated with preoperative and postoperative glycemic control. These findings support the concept that [beta-cell mass] rather than [alpha-cell mass] has a major role in regulating blood glucose level in humans.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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