Having a smaller pancreas and having higher levels of liver fat are both factors that predict who will develop type 2 diabetes, according to a new study published in the journal Diabetes Care.
It has long been known that having high levels of liver fat — the basis of nonalcoholic fatty liver disease (NAFLD) — is common in people with type 2 diabetes and obesity, and at least about 50% of people with diabetes will develop the condition. Many people with diabetes don’t known they have NAFLD, since it often causes no symptoms in its earlier stages. But no symptoms doesn’t mean no damage — studies have shown that having NAFLD is linked to a higher risk of dying, although it’s unclear how much of this risk comes from liver-related causes compared with other complications of diabetes and obesity. Detecting NAFLD is important because there are steps people can take to reverse it, or to stop or slow its progression — including dietary changes and, for people who are eligible, undergoing bariatric surgery.
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For the latest study, researchers at Brunel University London in England were interested in exploring whether having elevated levels of liver fat, or having a smaller pancreas, could play a role in the development of type 2 diabetes. Since both the pancreas and the liver are responsible for regulating blood glucose levels, it stands to reason that changes to either organ could play a role in the development of diabetes. The research performed a type of statistical analysis — known as Mendelian randomization — to look into whether liver fat and pancreas size could actually play a role in causing type 2 diabetes, rather than just being associated with it. To do this, they used data from genetic studies of people with both type 1 (9,358 participants) and type 2 (55,005 participants) diabetes.
Liver fat, pancreas size linked to type 2 risk
When looking at the raw data, the researchers found that both liver fat and overall liver volume were linked to the risk for type 2 diabetes. For every standard-deviation (a statistical measure of how far a number is from the other numbers) increase in liver fat, participants were 116% more likely to develop type 2 diabetes. For every standard-deviation increase in pancreas size, though, participants were 27% less likely to develop type 2 diabetes and 58% less likely to develop type 1 diabetes. When the researchers performed their Mendelian randomization analysis, they found evidence of causation only for type 2 diabetes — not for type 1. Based on this analysis, for every standard-deviation increase in liver fat, people were 27% more likely to develop type 2 diabetes — and for every standard-deviation increase in pancreas volume, people were 24% less likely to develop type 2.
The researchers noted that this study represents the first time genetic results have been used to demonstrate that liver fat and pancreas size play a role in the development of type 2 diabetes. And while it may be impossible to increase the size of your pancreas in a way that reduces your diabetes risk, the study’s results support the idea that taking proactive steps to reduce elevated liver fat could actually help prevent type 2 diabetes.
Want to learn more about type 2 diabetes? Read “Diagnostic Tests for Type 2 Diabetes” and “Welcome to Diabetes.”
