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Independent association between prediabetes and future pancreatic fat accumulation: a 5-year Japanese cohort study

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 12 May 2018

Abstract

Background

The association between pancreatic fat and glucose dysmetabolism has been reported in several cross-sectional studies; however, a recent longitudinal study showed that baseline pancreatic fat did not cause subsequent diabetes mellitus. We hypothesized that pancreatic fat is not a cause but a manifestation of glucose dysmetabolism and aimed to investigate the association between baseline prediabetes and future pancreatic fat accumulation.

Methods

Between 2008 and 2015, 198 nondiabetic participants, who underwent a health check-up via unenhanced computed tomography (CT) twice with CT intervals ≥ 5 years, were enrolled as prediabetes (n = 48) and non-prediabetes participants (n = 150). Prediabetes was defined as fasting plasma glucose of 100–125 mg/dl or hemoglobin A1c of 5.7–6.4%. Pancreatic fat was evaluated using a histologically validated method to measure the difference between pancreas and spleen attenuations (P–S) on CT. Pancreatic fat accumulation during follow-up was measured as P–S change from baseline. Multiple linear regression was used to evaluate the association between baseline prediabetes and future pancreatic fat accumulation with adjustment for age, sex, body mass index, physical activity, and liver fat at baseline.

Results

Mean pancreatic fat accumulation was 0.30 (SD, 5.8) Hounsfield units during follow-up. On univariate analysis, baseline prediabetes was associated with future pancreatic fat accumulation (β = 3.73; 95% CI 1.91–5.55; P < 0.001). This association remained statistically significant on multivariate analysis (β = 3.14; 95% CI 1.25–5.03; P = 0.001).

Conclusions

Prediabetes is a risk factor for future pancreatic fat accumulation. Pancreatic fat may be a manifestation of glucose dysmetabolism.

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Abbreviations

DM:

Diabetes mellitus

IR:

Insulin resistance

CT:

Computed tomography

FFA:

Free fatty acids

IFG:

Impaired fasting glucose

SD:

Standard deviation

FPG:

Fasting plasma glucose

HbA1c:

Hemoglobin A1c

NGSP:

National Glycohemoglobin Standardization Program

JDS:

Japan Diabetes Society

P–S:

Difference between pancreas and spleen attenuations

ROIs:

Round regions of interest

BMI:

Body mass index

L–S:

Difference between liver and spleen attenuations

β :

Regression coefficients

CIs:

Confidence intervals

HU:

Hounsfield units

HOMA-IR:

Homeostasis model assessment of insulin resistance

HR:

Hazard ratio

OGTT:

Oral glucose tolerance test

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Acknowledgements

The authors appreciate Keita Numata from the System Development Section, Keijinkai Maruyama Clinic; Kunihiko Hayashi, Hiromitsu Yonezawa, Eiji Kazuta, Kimihiro Saito, Keiko Takasaki, and Miyuki Yoshioka from the Department of Radiology, Keijinkai Maruyama Clinic; and Yuki Yoshino from the Department of Radiology, Teine Keijinkai Hospital, for assistance in data collection. We would also like to thank Editage (http://www.editage.jp) for English language editing.

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Authors and Affiliations

  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

    Hajime Yamazaki, Miho Kimachi, Yosuke Yamamoto & Shunichi Fukuhara

  2. Department of Radiology, Keijinkai Maruyama Clinic, 3-16, Odori Nishi 26-chome, Chuo-ku, Sapporo, 064-0820, Japan

    Shinichi Tauchi

  3. Department of Health Checkup and Promotion, Keijinkai Maruyama Clinic, 3-16, Odori Nishi 26-chome, Chuo-ku, Sapporo, 064-0820, Japan

    Mitsuru Dohke & Nagisa Hanawa

  4. Department of Radiology, Teine Keijinkai Hospital, 1-40, 1-jo 12-chome, Maeda, Teine-ku, Sapporo, 006-8555, Japan

    Yoshihisa Kodama

  5. Center for Gastroenterology, Teine Keijinkai Hospital, 1-40, 1-jo 12-chome, Maeda, Teine-ku, Sapporo, 006-8555, Japan

    Akio Katanuma

  6. Human Health Sciences, Kyoto University Graduate School of Medicine, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan

    Shingo Fukuma

Authors
  1. Hajime Yamazaki
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  2. Shinichi Tauchi
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  3. Miho Kimachi
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  4. Mitsuru Dohke
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  5. Nagisa Hanawa
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  6. Yoshihisa Kodama
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  7. Akio Katanuma
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  8. Yosuke Yamamoto
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  9. Shunichi Fukuhara
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  10. Shingo Fukuma
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Contributions

HY, MK, and SFukuma designed the study. ST, MD, NH, and YK collected the data. HY drafted the manuscript and analyzed the data. HY, ST, MK, MD, NH, YK, AK, YY, SFukuhara, and SFukuma reviewed, made critical revisions, and approved the article before submission. SFukuma is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Hajime Yamazaki.

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Conflict of interest

This study received no financial support relevant to this work. All authors have no potential conflicts of interest associated with this study.

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Yamazaki, H., Tauchi, S., Kimachi, M. et al. Independent association between prediabetes and future pancreatic fat accumulation: a 5-year Japanese cohort study. J Gastroenterol 53, 873–882 (2018). https://doi.org/10.1007/s00535-017-1422-2

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  • DOI: https://doi.org/10.1007/s00535-017-1422-2

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