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- Title
Quantitative Imaging Reveals Steatosis and Fibroinflammation in Multiple Organs in People With Type 2 Diabetes: A Real-World Study.
- Authors
Diamond, Charlie; Pansini, Michele; Hamid, Azlinda; Eichert, Nicole; Pandya, Prashant; Ali, Sarah N.; Kemp, Graham J.; Thanabalasingham, Gaya; Thomaides Brears, Helena; Cuthbertson, Daniel J.
- Abstract
We aimed to determine the extent of multiorgan fat accumulation and fibroinflammation in individuals living with type 2 diabetes. We deeply phenotyped individuals with type 2 diabetes (134 from secondary care, 69 from primary care) with multiorgan, quantitative, multiparametric MRI and compared with 134 matched control individuals without diabetes and 92 control individuals with normal weight. We examined the impact of diabetes duration, obesity status, and glycemic control. Ninety-three of the individuals with type 2 diabetes were reevaluated at 7 months (median). Multiorgan abnormalities were more common in individuals with type 2 diabetes (94%) than in age- and BMI-matched healthy individuals or healthy individuals with normal weight. We demonstrated a high burden of combined steatosis and fibroinflammation within the liver, pancreas, and kidneys (41%, 17%, and 10%) associated with visceral adiposity (73%) and poor vascular health (82%). Obesity was most closely associated with advanced liver disease, renal and visceral steatosis, and multiorgan abnormalities, while poor glycemic control was associated with pancreatic fibroinflammation. Pharmacological therapies with proven cardiorenal protection improved liver and vascular health unlike conventional glucose-lowering treatments, while weight loss or improved glycemic control reduced multiorgan adiposity (P ≤ 0.01). Quantitative imaging in people with type 2 diabetes highlights widespread organ abnormalities and may provide useful risk and treatment stratification. Article Highlights: Type 2 diabetes is a multisystem disease, but multiorgan imaging studies are lacking. The objective was to quantify organ abnormalities (steatosis and fibroinflammation) in type 2 diabetes using multiparametric MRI (mpMRI). In 126 of 134 individuals with type 2 diabetes, multiorgan abnormalities (steatosis and fibroinflammation) were detected with mpMRI, which persisted despite glucose-lowering therapy over 7 months. The therapeutic impact of new diabetes therapies on preventing or reversing end-organ damage can be measured by mpMRI.
- Subjects
TYPE 2 diabetes; GLYCEMIC control; FATTY degeneration; HYPERGLYCEMIA; SECONDARY care (Medicine); EXOCRINE pancreatic insufficiency
- Publication
Diabetes, 2024, Vol 73, Issue 8, p1285
- ISSN
0012-1797
- Publication type
Article
- DOI
10.2337/db23-0926