UF study links pancreas size to Type 1 diabetes risk
Published: Wednesday, December 12, 2012 at 4:28 p.m.
Last Modified: Wednesday, December 12, 2012 at 4:28 p.m.
People with smaller pancreases might be predisposed to Type 1 diabetes, according to a University of Florida study whose findings were published Wednesday in a research letter in the Journal of the American Medical Association.
The study, led by Dr. Martha Campbell-Thompson, a professor in the department of pathology, immunology and laboratory medicine at UF, measured the weight of organ donors' pancreases and found that people who had been diagnosed with Type 1 diabetes or who were at risk for the disease had smaller than average-sized pancreases.
"In weighing their pancreases, we saw that they had a smaller weight. It's suggesting that decreased weight could be a subclinical feature," Campbell-Thompson said.
A normal pancreas weighs about 80 grams, and the pancreases of people with Type 1 diabetes weighed about half that; people at risk for the disease had pancreases weighing about 60 grams.
The pancreas is responsible for producing insulin that the body needs to convert sugar to energy. When the pancreas stops producing insulin, diabetes occurs. Type 2 diabetes happens when people consume too many calories — or don't burn enough through exercise — and essentially wear out their own pancreases. But with Type 1 diabetes, thought to be largely a genetic condition, the body's own immune system turns on itself, and attacks the beta cells in the pancreas that make insulin.
The implication of Campbell-Thompson's study is that people with smaller pancreases also might have fewer beta cells.
"We still don't know what causes Type 1 diabetes, but if people have fewer beta cells to begin with, other confounding factors such as a virus or genetics could help push them over into having clinical diabetes. There are a lot of possibilities," Campbell-Thompson said, according to a UF news release Tuesday.
Campbell-Thompson said beta cells grow in utero and continue to develop until a child is about 5 years old. Type 1 diabetes is usually diagnosed in adolescents or young adults, most of whom have a first-degree relative — a parent or a sibling — with the disease.
Campbell-Thompson said the next step in research is to target young people already involved in clinical trials for Type 1 diabetes and measure the volume of their pancreases through MRI imaging. The study detailed in JAMA looked at adult organ donors. The only way to measure beta cell numbers in living people is through indirect tests, such as measuring glucose levels, Campbell-Thompson added.
"Our finding can't be considered conclusive at this point. There is still a lot to discover," she said.
Dr. Desmond Schatz, the medical director of the Diabetes Center of Excellence at UF, said the study "really gets at the heart of the mechanisms underlying Type 1 diabetes."
"We do not have any reliable markers in the peripheral blood what's actually happening in the pancreas, and it's such a difficult organ to access even with modern imaging techniques," Schatz said. "Studies such as this are vital to understand the etiology and pathogenesis of Type 1 diabetes."
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