Analysis of pancreatic volume in acute‐onset, slowly‐progressive and fulminant type 1 diabetes in a Japanese population

Sasamori, Hiroto; Fukui, Tetsuya; Hayashi, Toshiyuki; Yamamoto, Takakazu; Ohara, Makoto; Yamamoto, Satoshi; Kobayashi, Tetsuro; Hirano, Tsutomu

doi:10.1111/jdi.12816

Cited by 21 publications

(17 citation statements)

References 37 publications

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“…This observation suggests that the atrophy of the pancreas is likely to begin before the onset of T1D. Very recently, we also reported that the pancreatic volume assessed by CT was significantly reduced in the newly diagnosed acute-onset T1D patients, but not in the virus-induced fulminant T1D patients, when compared to non-diabetic controls (non-DCs) [15]. These findings suggest that the autoimmune process contributes to the pathogenesis of reduced PV in acute-onset T1D.…”

Section: Introductionsupporting

confidence: 52%

“…Iodine contrast medium ( Iomeron 300, Eisai, Tokyo, Japan; Omnipaque 300, Daiichi-Sankyo, Tokyo, Japan; Iopamiron 300, Bayer Health Care, Leverkusen, Germany) was intravenously injected at a rate of 3.0 mL/s by a power injector. The pancreas was manually outlined on axial image slices for semi-automatic calculation of the pancreatic volume using Ziostation2 (Ziosoft Inc., Tokyo, Japan) software according to the methods previously reported [15]. The areas of the slices were summed throughout the volume of the pancreas.…”

Section: Measurement Of Pancreatic Volumementioning

confidence: 99%

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Relationship Between Islet Autoantibodies and Pancreatic Volume in Type 1 Diabetes in Japanese Population

Fukase¹,

Fukui²,

Mori³

et al. 2019

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A total of 71 patients with T1D and 39 age-and body mass index (BMI)matched non-DCs from the Showa University Hospital (Tokyo, Japan) were selected for enrolment in the present retrospective study. The study was conducted by adding 37 patients with T1D to a population we studied in our previous research [15]. Based on the diagnostic criteria and clinical information ABSTRACT Objectives: Our group previously reported that the patients with type 1 diabetes had significantly lower pancreatic size than the non-diabetic controls (non-DCs). In the present study, we investigated the relationship between pancreas size and titers of islet autoantibodies in acute-onset type 1 diabetes and Oslowly progressive insulin-dependent diabetes mellitus (SPIDDM). Methods: The pancreatic volume (PV) was measured by computed tomography in 71 patients with type 1 diabetes (32 acute-onset type 1 diabetes and 39 SPIDDM) and 39 age-and body mass index-matched non-DCs. Autoantibody titers against glutamic acid decarboxylase antibody (GADAb), insulinomaassociated antigen-2 autoantibodies (IA-2Ab), and zinc transporter 8 autoantibody (ZnT8Ab) were measured. The ratio of 100 × random C-peptide (ng/mL) to plasma glucose levels (mg/dL). C-peptide index (CPI) was measured as the residual β-cell function. Results: The PV was significantly correlated with body weight in both the type 1 diabetes patients and the non-DCs. The PV index (PVI, PV/body weight) was decreased by 40% in the type 1 diabetes patients compared with that in the non-DCs. PVI in SPIDDM was reduced as the duration of diabetes progressed. No statistically significant correlation was found between the PVI and titers of GADAb and ZnT8Ab in acute-onset type 1 diabetes and SPIDDM. Among the patients with type 1 diabetes, PVI was significantly lower in patients with type 1 diabetes with a high titer of IA-2Ab (≥10 U/ml) compared with those with type 1 diabetes negative for IA-2Ab. The high IA-2Ab group had a high prevalence of acute-onset cases and titers of high GADAb and ZnT8Ab. Conclusion: High titers of IA-2Ab reflect reduced pancreatic size in the type 1 diabetes patients, especially those with an acute-onset form of the disease. The potential mechanisms underlying the reduced pancreatic size might differ between acute-onset type 1 diabetes and SPIDDM.

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Section: Introductionsupporting

confidence: 52%

Section: Measurement Of Pancreatic Volumementioning

confidence: 99%

Relationship Between Islet Autoantibodies and Pancreatic Volume in Type 1 Diabetes in Japanese Population

Fukase¹,

Fukui²,

Mori³

et al. 2019

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“…Sasamori et al recently revealed that unlike that in the participants with acute-onset type 1 diabetes and SPIDDM, pancreatic volume (PV) was not decreased in the participants (mainly) with classic fulminant type 1 diabetes, irrespective of disease duration, as compared with that in the control participants [16]. These findings suggest the possibility of no pre-existence of pancreatic inflammation until just before the onset of fulminant type 1 diabetes.…”

Section: Discussionmentioning

confidence: 95%

Clinical characteristics of anti-glutamic acid decarboxylase antibody-positive fulminant type 1 diabetes

et al. 2019

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This research aimed to examine the relationship between anti-glutamic acid decarboxylase antibody (GADA) titers and clinical parameters at onset and to clarify the association between clinical severity and GADA titers in GADA-positive fulminant type 1 diabetes. This cross-sectional observational study included 20 cases with GADA-positive fulminant type 1 diabetes (4 cases from our hospital and 16 from cases reported in the literature). The association between GADA titers and clinical parameters [age, sex, body weight, body mass index, period from appearance of any prodromal symptoms to diagnosis, period from development of hyperglycemic symptoms to diagnosis, GADA titer, HbA1c level, blood pH and HCO 3 level, serum levels of ketone bodies and pancreatic exocrine enzymes] were analyzed. Spearman's rank correlation coefficient (r s) was used for the correlation analysis. The results showed that there was a significant inverse correlation between GADA titers and the "period from appearance of any prodromal symptoms to diagnosis" (r s =-0.559, p < 0.05). Moreover, GADA titers were inversely correlated with blood pH and HCO 3 level (r s =-0.576, p < 0.05, r s =-0.578, p < 0.05, respectively), and positively correlated with serum levels of total ketone bodies, acetoacetate, and 3-hydroxybutyrate (r s = 0.661, p < 0.05; r s = 0.700, p < 0.05; and r s = 0.782, p < 0.01, respectively). These findings suggest that higher GADA titers may be linked to more severe clinical severity of GADA-positive fulminant type 1 diabetes at onset. This association may be attributed to possible pre-existence of autoimmunity-related β-cell damage before the onset of fulminant type 1 diabetes.

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“…Potential explanations for the reduction in pancreas size in type 1 diabetes include loss of insulinotrophic effects on acinar cells and immunologic destruction of exocrine pancreatic tissue (16). Interestingly, pancreatic size is also reduced in fulminant type 1 diabetes, type 2 diabetes, and monogenic diabetes, implicating potentially overlapping mechanisms related to b-cell dysfunction (17)(18)(19). Other factors that may impact pancreas size are likely complex interactions between genetics, epigenetics, and environmental agents (20).…”

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confidence: 99%

Relative Pancreas Volume Is Reduced in First-Degree Relatives of Patients With Type 1 Diabetes

et al. 2018

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OBJECTIVEPancreas size is reduced in patients at type 1 diabetes onset and in autoantibody (AAB)-positive donors without diabetes. We sought to determine whether pancreas volume (PV) imaging could improve understanding of the loss of pancreas size in first-degree relatives (FDRs) of patients with type 1 diabetes. We also examined relationships among PV, AAB status, and endocrine and exocrine functions. RESEARCH DESIGN AND METHODSWe conducted a cross-sectional study that included five groups: AAB 2 control subjects (no diabetes and no firstor second-degree relatives with type 1 diabetes) (N = 49), AAB 2 FDRs (N = 61), AAB + FDRs (N = 67 total: n = 31 with a single positive AAB [AAB + single] and n = 36 with multiple positive AABs [AAB + multiple]), and patients with recent-onset type 1 diabetes (<1 year) (N = 52). Fasting subjects underwent 1.5T pancreatic MRI, and PV and relative PV (RPV) (PV-to-BMI ratio) were analyzed between groups and for correlations with HbA 1c , C-peptide, glucose, and trypsinogen. RESULTSAll FDR groups had significantly lower RPV adjusted for BMI (RPV BMI ) than control subjects (all P < 0.05). Patients with type 1 diabetes had lower RPV BMI than AAB 2 FDR (P < 0.0001) and AAB + multiple (P £ 0.013) subjects. Transformed data indicated that trypsinogen levels were lowest in patients with type 1 diabetes. CONCLUSIONSThis study demonstrates, for the first time, all FDRs having significantly smaller RPV BMI compared with AAB 2 control subjects. Furthermore, RPV BMI was significantly lower in patients with recent-onset type 1 diabetes than in the AAB 2 FDR and AAB + multiple groups. As such, RPV BMI may be a novel noninvasive biomarker for predicting progression through stages of type 1 diabetes risk. This study highlights the potential paracrine relationships between the exocrine and endocrine pancreas in progression to type 1 diabetes in subjects at risk.Despite advances in medical diagnosis and treatment, type 1 diabetes remains one of the costliest diseases in the U.S. in terms of health care dollars spent for diabetesrelated costs (1). Immunotherapy-based intervention trials carried out in patients with new-onset type 1 diabetes have demonstrated potential for short-term benefit (e.g., anti-CD20, anti-CD3, and cytotoxic T-lymphocyte-associated antigen 4 Ig) but have failed to demonstrate long-term efficacy (2,3). The inability to provide long-term preservation of b-cell function or prevent type 1 diabetes may stem from unanswered

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Analysis of pancreatic volume in acute‐onset, slowly‐progressive and fulminant type 1 diabetes in a Japanese population

Cited by 21 publications

References 37 publications

Relationship Between Islet Autoantibodies and Pancreatic Volume in Type 1 Diabetes in Japanese Population

Relationship Between Islet Autoantibodies and Pancreatic Volume in Type 1 Diabetes in Japanese Population

Clinical characteristics of anti-glutamic acid decarboxylase antibody-positive fulminant type 1 diabetes

Relative Pancreas Volume Is Reduced in First-Degree Relatives of Patients With Type 1 Diabetes

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