2型糖尿病
脂肪变性
内科学
糖尿病
内分泌学
胰岛素抵抗
后备箱
胰岛素
医学
胰腺
脂肪肝
危险系数
生物
疾病
置信区间
生态学
作者
Hajime Yamazaki,Shinichi Tauchi,Jürgen Machann,Tobias Haueise,Yosuke Yamamoto,Mitsuru Dohke,Nagisa Hanawa,Yoshihisa Kodama,Akio Katanuma,Norbert Stefan,Andreas Fritsche,Andreas L. Birkenfeld,Róbert Wagner,Martin Heni
出处
期刊:Diabetes
[American Diabetes Association]
日期:2022-06-20
卷期号:71 (9): 1937-1945
被引量:20
摘要
Fat accumulation in the liver, pancreas, skeletal muscle, and visceral bed relates to type 2 diabetes (T2D). However, the distribution of fat among these compartments is heterogenous and whether specific distribution patterns indicate high T2D risk is unclear. We therefore investigated fat distribution patterns and their link to future T2D. From 2,168 individuals without diabetes who underwent computed tomography in Japan, this case-cohort study included 658 randomly selected individuals and 146 incident cases of T2D over 6 years of follow-up. Using data-driven analysis (k-means) based on fat content in the liver, pancreas, muscle, and visceral bed, we identified four fat distribution clusters: hepatic steatosis, pancreatic steatosis, trunk myosteatosis, and steatopenia. In comparisons with the steatopenia cluster, the adjusted hazard ratios for incident T2D were 4.02 (95% CI 2.27-7.12) for the hepatic steatosis cluster, 3.38 (1.65-6.91) for the pancreatic steatosis cluster, and 1.95 (1.07-3.54) for the trunk myosteatosis cluster. The clusters were replicated in 319 German individuals without diabetes who underwent MRI and metabolic phenotyping. The distribution of the glucose area under the curve across the four clusters found in Germany was similar to the distribution of T2D risk across the four clusters in Japan. Insulin sensitivity and insulin secretion differed across the four clusters. Thus, we identified patterns of fat distribution with different T2D risks presumably due to differences in insulin sensitivity and insulin secretion.
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