Abstract
Background: Skeletal muscle has been implicated in the pathogenesis of type 2 diabetes but it has never been investigated in diabetes after pancreatitis. The aim was to investigate the relationship between psoas muscle volume (PMV) and diabetes in individuals after pancreatitis, as well as its associations with ectopic fat phenotypes and insulin traits. Methods: Individuals after an attack of pancreatitis and healthy individuals were studied in a cross-sectional fashion. All participants underwent magnetic resonance imaging, based on which PMV, skeletal muscle fat deposition (SMFD), as well as liver and intra-pancreatic fat depositions were derived. Fasting and postprandial blood samples were collected to calculate indices of insulin sensitivity and secretion. Linear regression analyses were conducted, adjusting for possible confounders (age, sex, body composition, comorbidities, use of insulin, and others). Results: A total of 153 participants were studied. PMV was significantly decreased in the diabetes group compared with healthy controls (β = −30.0, p = 0.034 in the most adjusted model). SMFD was significantly inversely associated with PMV (β = −3.1, p < 0.001 in the most adjusted model). The Matsuda index of insulin sensitivity was significantly directly associated with PMV (β = 1.6, p = 0.010 in the most adjusted model). Conclusions: Diabetes in individuals after pancreatitis is characterized by reduced PMV. Reduced PMV is associated with increased SMFD and decreased insulin sensitivity in individuals after pancreatitis.
Highlights
Diabetes is a common multifaceted disease, with at least 450 million people affected by it worldwide [1]
The groupings were based on the American Diabetes Association guidelines, with normoglycemia defined as fasting plasma glucose < 5.6 mmol/L and glycated hemoglobin (HbA1c) < 39 mmol/mol; prediabetes—fasting plasma glucose between 5.6 mmol/L and 6.9 mmol/L and/or Glycated hemoglobin (HbA1c) between 39 and 47 mmol/mol; and diabetes—fasting plasma glucose > 7.0 mmol/L and/or HbA1c > 4.8 mmol/mol [20]
While some authors reported an increase in skeletal muscle size in diabetes, others found a decrease in it [31,32,33,34]
Summary
Diabetes is a common multifaceted disease, with at least 450 million people affected by it worldwide [1]. The global healthcare cost of managing people with diabetes is estimated to be at least US$ 850 billion [1] These data cover all types of the heterogeneous disease [2]. PPDM individuals are more likely to have poor glycemic control compared with those with type 2 diabetes mellitus (T2DM) [4]. Skeletal muscle has been implicated in the pathogenesis of type 2 diabetes but it has never been investigated in diabetes after pancreatitis. The aim was to investigate the relationship between psoas muscle volume (PMV) and diabetes in individuals after pancreatitis, as well as its associations with ectopic fat phenotypes and insulin traits. All participants underwent magnetic resonance imaging, based on which PMV, skeletal muscle fat deposition (SMFD), as well as liver and intra-pancreatic fat depositions were derived.
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