J Korean Diabetes Assoc.
2000 Oct;24(5):524-532.
Quantification of the Pancreatic -cell Mass in Normal and Type 2 Diabetic Subjects in Korea
- Affiliations
-
- 1Division of Endocrinology and Metabolism, Catholic Research Institutes of Medical Science.
- 2Department of Surgery, Kangnam St. Mary's Hospital, Catholic University of Korea, Seoul, Korea.
- 3Department of Pathology, Catholic University of Korea, Seoul, Korea.
Abstract
-
BACKGROUND: There have been several reports about insulin secretory impairment
in non-obese type 2 diabetic patients and even in impaired glucose tolerant
subjects in Korea. Insulin secretory impairment might be induced by insufficient
beta-cell mass, functional defects of beta-cells or both. To clarify the cause of
impaired insulin secretion in type 2 non-obese diabetic patients in Korea, beta-
cell masses were quantified in normal and type 2 diabetic subjects.
METHOD: Normal pancreases were procured by 6 heart-beating non-diabetic
donors under informed consent from relatives and approval of the university
ethical committee. To quantify the beta cell mass and insulin content in various
part of the pancreas, first we divided it into 3 parts: head, body and tail, and
then each three parts were weighed and subdivided again into 8 segments
equally. For diabetic patients, tissue sections were obtained from 15 partial or total
pancreatectomized type 2 diabetic patients of any causes. After being fixed,
tissues were immunostained using the Streptavidin-biotin-peroxidase method with
anti-insulin antibody. Beta cells were counted by point count method.
RESULTS
The mean value of total pancreas weight of normal subjects (n=6) was
77.1+/-14.6 g, that of mean relative volume of beta cells in the pancreas was 2.1+/-
0.9%, ranging from 1.4% to 3.1% (head 2.3+/-0.6%, body 1.8+/-0.2%, tail 2.2+/-0.4%).
Mean value of total beta cell mass which was calculated from relative volume of
beta-cells and weight of each portions was 1.3+/-0.3 g, ranging from 1.2 g to 1.9 g
(head 0.6+/-0.3 g, body 0.4+/-0.2 g, tail 0.4+/-0.2 g). Mean insulin content per
pancreas was 63.6+/-46.6 g, ranging from 27.8 to 137.2 g/pancreas (head 25.1+/-
19.1 g, body 20.8+/-15.5 g, tail 17.7+/-14.9 g). In diabetic patients, relative volume
of beta cells in tissues were variable from 0.4% to 2.8% and there was good
correlation between beta-cell mass and body mass index of the diabetic patients.
However we can't find the correlation among relative volume of beta-cell,
(r2=0.55, p<0.05) duration of diabetes and age. Remarkable heterogeneity for loss
of beta-cells in the islets of diabetic patients was observed even in the same lobe
of pancreas. There were no evidence of lymphocytic infiltration in the islets.
CONCLUSION
Insufficient beta cell mass seems to be a main cause for insulin
secretory impairment in non-obese type 2 diabetic patients in Korea.