Non‐invasive imaging of functional pancreatic islet beta‐cell mass in people with type 1 diabetes mellitus

Shruti S. Joshi, Trisha Singh, Lucy E. Kershaw, Fraser W. Gibb, Marc R. Dweck, Michelle Williams, Iskandar Idris, Scott Semple, Shareen Forbes, David E. Newby, Rebecca M. Reynolds

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: To investigate whether manganese-enhanced
magnetic resonance imaging
can assess functional pancreatic beta-cell
mass in people with type 1 diabetes mellitus.
Methods: In a prospective case–control
study, 20 people with type 1 diabetes
mellitus (10 with low (≥50 pmol/L) and 10 with very low (concentrations) and 15 healthy volunteers underwent manganese-enhanced
magnetic resonance imaging of the pancreas following an oral glucose load. Scan-rescan
reproducibility was performed in 10 participants.
Results: Mean pancreatic manganese uptake was 31 ± 6 mL/100 g of tissue/min
in healthy volunteers (median 32 [interquartile range 23–36]
years, 6 women),
falling to 23 ± 4 and 13 ± 5 mL/100 g of tissue/min (p ≤ 0.002 for both) in people
with type1 diabetes mellitus (52 [44–61]
years, 6 women) and low or very low
plasma C-peptide
concentrations respectively. Pancreatic manganese uptake
correlated strongly with plasma C-peptide
concentrations in people with type1
diabetes mellitus (r = 0.73, p < 0.001) but not in healthy volunteers (r = −0.054,
p = 0.880). There were no statistically significant correlations between manganese
uptake and age, body-mass
index, or glycated haemoglobin. There was strong
intra-observer
(mean difference: 0.31 (limits of agreement −1.42 to 2.05) mL/100 g
of tissue/min; intra-class
correlation, ICC = 0.99), inter-observer
(−1.23 (−5.74 to
3.27) mL/100 g of tissue/min; ICC = 0.85) and scan-rescan
(−0.72 (−2.9 to 1.6)
mL/100 g of tissue/min; ICC = 0.96) agreement for pancreatic manganese uptake.
Conclusions: Manganese-enhanced
magnetic resonance imaging provides a potential
reproducible non-invasive
measure of functional beta-cell
mass in people with type
1 diabetes mellitus. This holds major promise for investigating type 1 diabetes, monitoring
disease progression and assessing novel immunomodulatory interventions.
Original languageEnglish
JournalDiabetic Medicine
DOIs
Publication statusPublished - 10 Apr 2023

Keywords / Materials (for Non-textual outputs)

  • magnetic resonance imaging,
  • pancreatic beta-cells
  • Type 1 diabetes mellitus

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