Hajime Yamazaki1,2, Shinichi Tauchi3, Jui Wang4,5, Mitsuru Dohke6, Nagisa Hanawa6, Yoshihisa Kodama7, Akio Katanuma8, Yoshifumi Saisho9, Tsukasa Kamitani4, Shunichi Fukuhara4, Yosuke Yamamoto4. 1. Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan. yamazaki-myz@umin.ac.jp. 2. Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Syogoin, Sakyo-ku, Kyoto, 606-8507, Japan. yamazaki-myz@umin.ac.jp. 3. Department of Radiology, Keijinkai Maruyama Clinic, 3-16, Odori Nishi 26-chome, Chuo-ku, Sapporo, 064-0820, Japan. 4. Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan. 5. Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Room 517, No. 17, Xu-Zhou Road, Taipei, 100, Taiwan. 6. Department of Health Checkup and Promotion, Keijinkai Maruyama Clinic, 3-16, Odori Nishi 26-chome, Chuo-ku, Sapporo, 064-0820, Japan. 7. Department of Radiology, Teine Keijinkai Hospital, 1-40, 1-jo 12-chome, Maeda, Teine-ku, Sapporo, 006-8555, Japan. 8. Center for Gastroenterology, Teine Keijinkai Hospital, 1-40, 1-jo 12-chome, Maeda, Teine-ku, Sapporo, 006-8555, Japan. 9. Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Abstract
BACKGROUND: Only a few studies have longitudinally evaluated whether fatty pancreas increases the risk of type-2 diabetes (T2D), and their results were inconsistent. Fatty pancreas is closely linked to overweight and obesity, but previous studies did not exclude overweight or obese individuals. Therefore, in this cohort study, we investigated the association between fatty pancreas and T2D incidence in lean individuals. METHODS: Between 2008 and 2013, 1478 nondiabetic lean individuals (i.e. body-mass index < 25 kg/m2) underwent health examinations including computed tomography (CT) and were followed for a median of 6.19 years. Fatty pancreas was evaluated by a histologically-validated method using pancreas attenuation (Hounsfield units [HU]) on CT at baseline; lower pancreas attenuation indicates more pancreatic fat. To detect incident T2D, we used fasting plasma glucose, HbA1c, and self-reports of prescribed anti-diabetes medications. Odds ratios (OR) for the association between pancreas attenuation and incident T2D were estimated using logistic regression models adjusted for likely confounders. RESULTS: T2D occurred in 61 participants (4.13%) during the follow-up period. Lower pancreas attenuation (i.e. more pancreatic fat) at baseline was associated with incident T2D (unadjusted OR per 10 HU lower attenuation: 1.56 [95% CI 1.28-1.91], p < 0.001). The multivariable-adjusted analysis revealed a similar association (adjusted OR per 10 HU lower attenuation: 1.32 [95% CI 1.06-1.63], p = 0.012). CONCLUSIONS: T2D was likely to develop in lean individuals with the fatty pancreas. Among people who are neither obese nor overweight, the fatty pancreas can be used to define a group at high risk for T2D.
BACKGROUND: Only a few studies have longitudinally evaluated whether fatty pancreas increases the risk of type-2 diabetes (T2D), and their results were inconsistent. Fatty pancreas is closely linked to overweight and obesity, but previous studies did not exclude overweight or obese individuals. Therefore, in this cohort study, we investigated the association between fatty pancreas and T2D incidence in lean individuals. METHODS: Between 2008 and 2013, 1478 nondiabetic lean individuals (i.e. body-mass index < 25 kg/m2) underwent health examinations including computed tomography (CT) and were followed for a median of 6.19 years. Fatty pancreas was evaluated by a histologically-validated method using pancreas attenuation (Hounsfield units [HU]) on CT at baseline; lower pancreas attenuation indicates more pancreatic fat. To detect incident T2D, we used fasting plasma glucose, HbA1c, and self-reports of prescribed anti-diabetes medications. Odds ratios (OR) for the association between pancreas attenuation and incident T2D were estimated using logistic regression models adjusted for likely confounders. RESULTS:T2D occurred in 61 participants (4.13%) during the follow-up period. Lower pancreas attenuation (i.e. more pancreatic fat) at baseline was associated with incident T2D (unadjusted OR per 10 HU lower attenuation: 1.56 [95% CI 1.28-1.91], p < 0.001). The multivariable-adjusted analysis revealed a similar association (adjusted OR per 10 HU lower attenuation: 1.32 [95% CI 1.06-1.63], p = 0.012). CONCLUSIONS:T2D was likely to develop in lean individuals with the fatty pancreas. Among people who are neither obese nor overweight, the fatty pancreas can be used to define a group at high risk for T2D.
Authors: Robert Wagner; Sabine S Eckstein; Hajime Yamazaki; Felicia Gerst; Jürgen Machann; Benjamin Assad Jaghutriz; Annette Schürmann; Michele Solimena; Stephan Singer; Alfred Königsrainer; Andreas L Birkenfeld; Hans-Ulrich Häring; Andreas Fritsche; Susanne Ullrich; Martin Heni Journal: Nat Rev Endocrinol Date: 2021-10-20 Impact factor: 43.330
Authors: Róbert Wagner; Benjamin Assad Jaghutriz; Felicia Gerst; Morgana Barroso Oquendo; Jürgen Machann; Fritz Schick; Markus W Löffler; Silvio Nadalin; Falko Fend; Alfred Königsrainer; Andreas Peter; Dorothea Siegel-Axel; Susanne Ullrich; Hans-Ulrich Häring; Andreas Fritsche; Martin Heni Journal: J Clin Endocrinol Metab Date: 2020-11-01 Impact factor: 5.958
Authors: Ahmed Abdallah Salman; Mohamed Abdalla Salman; Mostafa Said; Mohammad El Sherbiny; Hesham Elkassar; Mohamed Badr Hassan; Ahmed Marwan; Mohamed Abdelkader Morad; Omar Ashoush; Safa Labib; Mohamed H Aon; Abeer Awad; Mohamed Sayed; Ahmed E Taha; Ahmed Moustafa; Hossam El-Din Shaaban; Amir Khater; Ahmed Elewa; Adel M Khalaf; Ahmed A Mostafa; Mohamed Matter; Ahmed Youssef Journal: Front Med (Lausanne) Date: 2022-06-06