American Diabetes Association
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fDiamond_MultiorganMRI_in_T2D_Supplementary_DB23_0926_R2.pdf (745.82 kB)

Quantitative imaging reveals steatosis and fibro-inflammation in multiple organs in people with type 2 diabetes: a real-world study.

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posted on 2024-05-15, 15:50 authored by Charlie Diamond, Michele Pansini, Azlinda Hamid, Nicole Eichert, Prashant Pandya, Sarah N Ali, Graham J Kemp, Gaya Thanabalasingham, Helena Thomaides Brears, Daniel J Cuthbertson

We aimed to determine the extent of multi-organ fat accumulation and fibro-inflammation in individuals living with type 2 diabetes. We deeply phenotyped individuals with type 2 diabetes (134 from secondary care, 69 from primary care) with multi-organ, quantitative multi-parametric MRI and compared with 134 matched controls and 92 normal weight controls. We examined the impact of diabetes duration, obesity status and glycemic control. Ninety-three of the individuals with type 2 diabetes were re-evaluated at 7 months (median). Multi-organ abnormalities were more common in individuals with type 2 diabetes (94%) than in age, BMI-matched healthy or healthy normal weight people. We demonstrated a high burden of combined steatosis and fibro-inflammation, 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 multi-organ abnormalities whilst poor glycaemic control was associated with pancreatic fibro-inflammation. Pharmacological therapies with proven cardiorenal protection improved liver and vascular health unlike conventional glucose-lowering treatments, whilst weight loss or improved glycaemic control reduced multi-organ adiposity (p£0.01). Quantitative imaging in people with type 2 diabetes highlights widespread organ abnormalities and may provide useful risk and treatment stratification.

Funding

Funding assistance for this was provided from a joint Innovate UK award (Digital Health Technology Catalyst round 3) to HTB, DC, GT, GJK, SA. UK Biobank data were accessed through application 9914.

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