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Weight Loss Decreases Excess Pancreatic Triacylglycerol Specifically in Type 2 Diabetes

Lookup NU author(s): Dr Sarah Steven, Dr Kieren Hollingsworth, Dr Benjamin Aribisala, Dr Ahmad Al-Mrabeh, Professor Ann Daly, Professor Roy Taylor

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This is the authors' accepted manuscript of an article that has been published in its final definitive form by American Diabetes Association, 2016.

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Abstract

OBJECTIVEThis study determined whether the decrease in pancreatic triacylglycerol during weight loss in type 2 diabetes mellitus (T2DM) is simply reflective of whole-body fat or specific to diabetes and associated with the simultaneous recovery of insulin secretory function.RESEARCH DESIGN AND METHODSIndividuals listed for gastric bypass surgery who had T2DM or normal glucose tolerance (NGT) matched for age, weight, and sex were studied before and 8 weeks after surgery. Pancreas and liver triacylglycerol were quantified using in phase, out-of-phase MRI. Also measured were the first-phase insulin response to a stepped intravenous glucose infusion, hepatic insulin sensitivity, and glycemic and incretin responses to a semisolid test meal.RESULTSWeight loss after surgery was similar (NGT: 12.8 +/- 0.8% and T2DM: 13.6 +/- 0.7%) as was the change in fat mass (56.7 +/- 3.3 to 45.4 +/- 2.3 vs. 56.6 +/- 2.4 to 43.0 +/- 2.4 kg). Pancreatic triacylglycerol did not change in NGT (5.1 +/- 0.2 to 5.5 +/- 0.4%) but decreased in the group with T2DM (6.6 +/- 0.5 to 5.4 +/- 0.4%; P = 0.007). First-phase insulin response to a stepped intravenous glucose infusion did not change in NGT (0.24 [0.13-0.46] to 0.23 [0.19-0.37] nmol . min(-1) . m(-2)) but normalized in T2DM (0.08 [20.01 to -0.10] to 0.22 [0.07-0.30]) nmol . min(-1) . m(-2) at week 8 (P = 0.005). No differential effect of incretin secretion was observed after gastric bypass, with more rapid glucose absorption bringing about equivalently enhanced glucagon-like peptide 1 secretion in the two groups.CONCLUSIONSThe fall in intrapancreatic triacylglycerol in T2DM, which occurs during weight loss, is associated with the condition itself rather than decreased total body fat.


Publication metadata

Author(s): Steven S, Hollingsworth KG, Small PK, Woodcock SA, Pucci A, Aribisala B, Al-Mrabeh A, Daly AK, Batterham RL, Taylor R

Publication type: Article

Publication status: Published

Journal: Diabetes Care

Year: 2016

Volume: 39

Issue: 1

Pages: 158-165

Print publication date: 01/01/2016

Online publication date: 01/12/2015

Acceptance date: 22/07/2015

ISSN (print): 0149-5992

ISSN (electronic): 1935-5548

Publisher: American Diabetes Association

URL: http://dx.doi.org/10.2337/dc15-0750

DOI: 10.2337/dc15-0750


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