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

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

Abstract

To investigate whether manganese-enhanced magnetic resonance imaging can assess functional pancreatic beta-cell mass in people with type 1 diabetes mellitus. In a prospective case-control study, 20 people with type 1 diabetes mellitus (10 with low (≥50 pmol/L) and 10 with very low (<50 pmol/L) C-peptide 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. 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. 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. [Abstract copyright: © 2023 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.]

• Journal Article Type: Article
• Acceptance Date: Apr 6, 2023
• Online Publication Date: Apr 10, 2023
• Publication Date: 2023-10
• Deposit Date: Sep 27, 2023
• Publicly Available Date: Sep 27, 2023
• Journal: Diabetic Medicine
• Print ISSN: 0742-3071
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 40
• Issue: 10
• Article Number: e15111
• DOI: https://doi.org/10.1111/dme.15111
• Keywords: pancreatic beta-cells, magnetic resonance imaging, type 1 diabetes mellitus
• Public URL: https://nottingham-repository.worktribe.com/output/19992770
• Publisher URL: https://onlinelibrary.wiley.com/doi/full/10.1111/dme.15111