Liver, pancreatic fat higher in people with type 2 diabetes in all BMI groups
Click Here to Manage Email Alerts
Adults with type 2 diabetes have more liver and intrapancreatic fat across all BMI levels than those without diabetes, and weight loss can help to reduce intra-organ fat to achieve disease remission, according to a speaker.
“Doctors often use ‘normal’ ranges to say whether a person has healthy fat levels inside the liver and pancreas, but the healthy level for a heavy person may be very different from that for a slim person,” Roy Taylor, MD, professor of medicine and metabolism at Newcastle University, United Kingdom, told Healio. “We show that people with type 2 diabetes, even though they are slim, actually have levels of liver fat which are in the ‘normal’ range, but weight loss reduces these to a proper level.”
Taylor presented study findings at the European Association for the Study of Diabetes virtual meeting.
Taylor and colleagues analyzed data from 56 adults with type 2 diabetes and overweight or obesity in the Diabetes Remission Clinical Trial (DiRECT; mean age, 53.3 years; mean BMI, 35.1 kg/m2) and 15 adults with type 2 diabetes and normal weight in the Reversal of Type 2 Diabetes upon Normalization of Energy Intake in the Non-obese (ReTUNE) trial (mean age, 58.2 years; mean BMI, 24.3 kg/m2). ReTUNE is ongoing, but the preliminary data show clear findings. In both studies, participants followed a weight-management intervention in which they aimed to lose 10% to 15% of body weight by consuming less than 800 kcal per day and then maintain that weight. Intra-organ fat was measured through 3-point Dixon magnetic resonance. The DiRECT cohort was compared with an age, sex and BMI-matched control group without diabetes (n = 18; mean age, 55.4 years), and the ReTUNE cohort was compared with a separate age, sex and BMI matched control cohort without diabetes (n = 11; mean age, 58.8 years).
The DiRECT diabetes cohort had a higher percentage of liver fat (16% vs. 5.5%; P < .0001) and intrapancreatic fat (8.5% vs. 6.8%; P < .01) compared with its matched control group at baseline. Similarly, ReTUNE participants with diabetes had greater liver fat (4.7% vs. 1.9%; P = .016) and intrapancreatic fat (5% vs. 3.4%; P = .029) compared with their control group. Participants with diabetes and controls with a BMI greater than 27 kg/m2 had higher liver and intrapancreatic fat than those with a normal BMI.
After the intervention, the DiRECT participants with diabetes had a decrease in liver fat to 3% and intrapancreatic fat to 7.6%. ReTUNE participants with diabetes also saw liver fat decrease to 1.4% and intrapancreatic fat to 4.5%. Diabetes remission without medication was observed in 60% of the DiRECT and 67% of ReTUNE participants with diabetes at baseline.
"It’s clear that if an individual has type 2 diabetes, they have more fat inside their body than they can cope with, even if they seem to be slim,” Taylor said in a press release. "These results also show that levels of liver fat vary with weight, and that levels currently considered to be healthy can actually be harmful in lighter people. At present, it is assumed that a liver fat level of less than 5.5% is healthy, whatever a person's BMI. We need to change the way we assess liver fat to take into account BMI."
Collapse
Taylor R, et al. Oral presentation 110. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 27-Oct. 1, 2021 (virtual meeting).
Read more about
Click Here to Manage Email Alerts