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β-cell mass in people with type 2 diabetes.

Cho JH, Kim JW, Shin JA, Shin J, Yoon KH - J Diabetes Investig (2011)

Bottom Line: Furthermore, β-cell volumes are reduced even in patients with impaired fasting glucose.Such defects in β-cell mass are associated with increased apoptosis rather than insufficient replication or neogenesis of β-cells.With these results, although they still require clarification, the peak β-cell mass might be determined at quite an early stage of life, and then might decline progressively over time as the result of exposure to harmful environmental influences over one's lifetime.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.

ABSTRACT
The early occurrence of β-cell dysfunction has been broadly recognized as a critical determinant of the development and progression of type 2 diabetes. β-cell dysfunction might be induced by insufficient β-cell mass, by a dysfunction of the β-cells, or both. Whether or not β-cell dysfunction constitutes a cause of reduced β-cells or vice-versa currently remains unclear. The results of some studies have measured the loss of β-cells in type 2 diabetic patients at between 22 and 63% by planimetric measurements. Because β-cell hypertrophy has been noted in type 2 diabetic patients, the loss of β-cell number should prove more profound than what has thus far been reported. Furthermore, β-cell volumes are reduced even in patients with impaired fasting glucose. Such defects in β-cell mass are associated with increased apoptosis rather than insufficient replication or neogenesis of β-cells. With these results, although they still require clarification, the peak β-cell mass might be determined at quite an early stage of life, and then might decline progressively over time as the result of exposure to harmful environmental influences over one's lifetime. In this review, we have summarized the relevant studies regarding β-cell mass in patients with type 2 diabetes, and then presented a review of the various causes of β-cell loss in adults. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2010.00072.x, 2010).

No MeSH data available.


Related in: MedlinePlus

 (a) The body mass index (BMI) and β‐cell mass were linearly correlated in control group 1 (r2 = 0.64, P = 0.003) and diabetic patients (r2 = 0.55, P < 0.05). Remarkably, the mean value of the relative volume of β‐cells in diabetic patients was lower than those of other control groups (adapted fromYoon et al.). (b) The pattern of distribution of β‐cells (%) among groups whose BMI ranges were between 21 and 25 kg/m2. The mean value of the relative volume of β‐cells in diabetic patients was lower than those of other control groups (adapted from Yoon et al., Copyright 2003, The Endocrine Society).
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f1:  (a) The body mass index (BMI) and β‐cell mass were linearly correlated in control group 1 (r2 = 0.64, P = 0.003) and diabetic patients (r2 = 0.55, P < 0.05). Remarkably, the mean value of the relative volume of β‐cells in diabetic patients was lower than those of other control groups (adapted fromYoon et al.). (b) The pattern of distribution of β‐cells (%) among groups whose BMI ranges were between 21 and 25 kg/m2. The mean value of the relative volume of β‐cells in diabetic patients was lower than those of other control groups (adapted from Yoon et al., Copyright 2003, The Endocrine Society).

Mentions: β‐cell mass is determined as the sum of replication, neogenesis and hypertrophy minus the rate of apoptosis. Normally, obesity, pregnancy and increases in insulin resistance are the principal causes of β‐cell mass increases, through enhanced replication, neogenesis and hypertrophy. However, the progression from an insulin resistance condition to diabetes is inevitably associated with β‐cell dysfunction and reduced β‐cell mass5,6. Many previous studies have reported that β‐cell mass in type 2 diabetic subjects tends to be reduced relative to normal subjects. Saito et al.7 reported previously that the total islet number was approximately 30% lower in subjects with type 2 diabetes relative to the non‐diabetic subjects. In the same year, Westermark and Wilander8 also noted a 30% reduction in the total islet volumes of diabetic subjects. The islet volume of the diabetic patients was 1.01 ± 0.12 cm3 and that of the non‐diabetic patients was 1.60 ± 0.16 cm3. In 2002, Sakuraba et al.9 reported a 22–30% reduction in β‐cell volume, as well as a 22% reduction in the quantity of islets in Japanese type 2 diabetic patients. In 2003, Butler et al. reported that obese humans with type 2 diabetes evidenced a 63% deficit in relative β‐cell volume relative to non‐diabetic obese subjects, although the relative β‐cell volumes were increased in obese vs lean non‐diabetic cases. Lean subjects with type 2 diabetes also evidenced a 41% deficit in relative β‐cell volumes10. In 2003, we also showed that β‐cell mass was reduced in Korean type 2 diabetes patients. The mean relative volume of β‐cells was reduced by approximately 50% relative to normal subjects (Figure 1)11. Recently, Rahier et al.12 clearly showed that β‐cell mass decreased by approximately 39%, occurring similarly in the body and tail of the pancreatic islets in European subjects with type 2 diabetes. All together, we could agree that 30–60% of β‐cell mass was decreased in patients with type 2 diabetes mellitus and we also observed unexpected broad heterogeneity of β‐cell mass in each patient in many studies.


β-cell mass in people with type 2 diabetes.

Cho JH, Kim JW, Shin JA, Shin J, Yoon KH - J Diabetes Investig (2011)

 (a) The body mass index (BMI) and β‐cell mass were linearly correlated in control group 1 (r2 = 0.64, P = 0.003) and diabetic patients (r2 = 0.55, P < 0.05). Remarkably, the mean value of the relative volume of β‐cells in diabetic patients was lower than those of other control groups (adapted fromYoon et al.). (b) The pattern of distribution of β‐cells (%) among groups whose BMI ranges were between 21 and 25 kg/m2. The mean value of the relative volume of β‐cells in diabetic patients was lower than those of other control groups (adapted from Yoon et al., Copyright 2003, The Endocrine Society).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4008010&req=5

f1:  (a) The body mass index (BMI) and β‐cell mass were linearly correlated in control group 1 (r2 = 0.64, P = 0.003) and diabetic patients (r2 = 0.55, P < 0.05). Remarkably, the mean value of the relative volume of β‐cells in diabetic patients was lower than those of other control groups (adapted fromYoon et al.). (b) The pattern of distribution of β‐cells (%) among groups whose BMI ranges were between 21 and 25 kg/m2. The mean value of the relative volume of β‐cells in diabetic patients was lower than those of other control groups (adapted from Yoon et al., Copyright 2003, The Endocrine Society).
Mentions: β‐cell mass is determined as the sum of replication, neogenesis and hypertrophy minus the rate of apoptosis. Normally, obesity, pregnancy and increases in insulin resistance are the principal causes of β‐cell mass increases, through enhanced replication, neogenesis and hypertrophy. However, the progression from an insulin resistance condition to diabetes is inevitably associated with β‐cell dysfunction and reduced β‐cell mass5,6. Many previous studies have reported that β‐cell mass in type 2 diabetic subjects tends to be reduced relative to normal subjects. Saito et al.7 reported previously that the total islet number was approximately 30% lower in subjects with type 2 diabetes relative to the non‐diabetic subjects. In the same year, Westermark and Wilander8 also noted a 30% reduction in the total islet volumes of diabetic subjects. The islet volume of the diabetic patients was 1.01 ± 0.12 cm3 and that of the non‐diabetic patients was 1.60 ± 0.16 cm3. In 2002, Sakuraba et al.9 reported a 22–30% reduction in β‐cell volume, as well as a 22% reduction in the quantity of islets in Japanese type 2 diabetic patients. In 2003, Butler et al. reported that obese humans with type 2 diabetes evidenced a 63% deficit in relative β‐cell volume relative to non‐diabetic obese subjects, although the relative β‐cell volumes were increased in obese vs lean non‐diabetic cases. Lean subjects with type 2 diabetes also evidenced a 41% deficit in relative β‐cell volumes10. In 2003, we also showed that β‐cell mass was reduced in Korean type 2 diabetes patients. The mean relative volume of β‐cells was reduced by approximately 50% relative to normal subjects (Figure 1)11. Recently, Rahier et al.12 clearly showed that β‐cell mass decreased by approximately 39%, occurring similarly in the body and tail of the pancreatic islets in European subjects with type 2 diabetes. All together, we could agree that 30–60% of β‐cell mass was decreased in patients with type 2 diabetes mellitus and we also observed unexpected broad heterogeneity of β‐cell mass in each patient in many studies.

Bottom Line: Furthermore, β-cell volumes are reduced even in patients with impaired fasting glucose.Such defects in β-cell mass are associated with increased apoptosis rather than insufficient replication or neogenesis of β-cells.With these results, although they still require clarification, the peak β-cell mass might be determined at quite an early stage of life, and then might decline progressively over time as the result of exposure to harmful environmental influences over one's lifetime.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.

ABSTRACT
The early occurrence of β-cell dysfunction has been broadly recognized as a critical determinant of the development and progression of type 2 diabetes. β-cell dysfunction might be induced by insufficient β-cell mass, by a dysfunction of the β-cells, or both. Whether or not β-cell dysfunction constitutes a cause of reduced β-cells or vice-versa currently remains unclear. The results of some studies have measured the loss of β-cells in type 2 diabetic patients at between 22 and 63% by planimetric measurements. Because β-cell hypertrophy has been noted in type 2 diabetic patients, the loss of β-cell number should prove more profound than what has thus far been reported. Furthermore, β-cell volumes are reduced even in patients with impaired fasting glucose. Such defects in β-cell mass are associated with increased apoptosis rather than insufficient replication or neogenesis of β-cells. With these results, although they still require clarification, the peak β-cell mass might be determined at quite an early stage of life, and then might decline progressively over time as the result of exposure to harmful environmental influences over one's lifetime. In this review, we have summarized the relevant studies regarding β-cell mass in patients with type 2 diabetes, and then presented a review of the various causes of β-cell loss in adults. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2010.00072.x, 2010).

No MeSH data available.


Related in: MedlinePlus