New Type 2 Diabetes Risk Factors Identified

Zarrin Hossain

January 05, 2022

Type 2 diabetes (T2D) is associated with a number of risk factors and now new research, published in Diabetes Care, suggests that increased levels of liver fat and a smaller pancreas volume may also add to a greater risk of developing T2D.

Head of Research Communications at Diabetes UK, Dr Lucy Chambers, commented that this breakthrough study "offers new insights into the causes of type 2 diabetes that, as we move towards an era of personalised medicine, could in future help us to improve the way we predict, prevent and treat the condition."

"Our results provide the first genetic evidence that the decrease in pancreas volume may be causal of type 2 diabetes," said study lead and Diabetes UK RD Lawrence Fellow, Dr Hanieh Yaghootkar.

The new study, conducted at Brunel University, used data collected from 32,859 people who underwent an MRI as part of the UK Biobank study. Data from 9358 participants with type 1 diabetes was also collected from various genome-wide association studies.

"People with type 2 diabetes usually have excess fat in their liver and pancreas, the two key organs in the maintenance of the normal level of blood sugar. The genetic analysis we used in this study is the best possible method to test this relationship," says Dr Yaghootkar.

Details of the Study

Researchers conducted inverse-variance weighted Mendelian randomisation to analyse whether these factors could have a casual role in the development of T2D. Overall, 51.5% of participants were women and the mean age of participants was 63.9 years.

Results showed that a larger liver volume was associated with a higher risk of T2D but no direct correlation with T2D was observed. However, a smaller pancreas volume played a causal role in increasing the risk of T2D (OR: 0.76, 95% CI 0.62 to 0.94) – the higher the pancreas volume, a 24% decreased risk of developing T2D was noted.

"We also showed that people with genes that make them more likely to have a smaller pancreas have a higher risk of type 2 diabetes. These results suggest that underlying mechanisms associated with reduced pancreatic volume precede diagnosis of type 2 diabetes," said Dr Yaghootkar.

An increased liver fat content correlated with a greater risk of having T2D – a 5% increase in liver fat (OR 2.16, 95% CI 2.02 to 2.31) accounted for a 27% increase in the risk for T2D (OR 1.27, 95% CI 1.08 to 1.49). Similarly, a higher proportion of fat in the pancreas was associated with an increased risk of T2D but no direct link was found, eliminating this factor.

No causal evidence was found for participants who had type 1 diabetes.

Hope to Better Understand Causes of T2D

"Our results encourage better treatment of those living with non-alcoholic fatty liver disease, and provide evidence for the multiple benefits of weight loss and better screening for diabetes risk in these people," said Dr Yaghootkar.

"We hope by better characterisation of fat in different organs and also different organ size in the future, we can provide better understanding of the mechanisms that cause type 2 diabetes."

Dr Chambers added, "Knowing your overall risk of type 2 diabetes is the first step in accessing support, such as prevention programmes, to help reduce your risk."



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