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Complications
The Association between Pancreatic Steatosis and Diabetic Retinopathy in Type 2 Diabetes Mellitus Patients
Jee Sun Jeong, Mee Kyung Kim, Kyung Do Han, Oak Kee Hong, Ki-Hyun Baek, Ki-Ho Song, Dong Jin Chung, Jung-Min Lee, Hyuk-Sang Kwon
Diabetes Metab J. 2018;42(5):425-432.   Published online August 9, 2018
DOI: https://doi.org/10.4093/dmj.2017.0107
  • 4,076 View
  • 43 Download
  • 5 Web of Science
  • 4 Crossref
AbstractAbstract PDFPubReader   
Background

Whether pancreatic steatosis has a local or systemic effect, like ectopic fat of other major organs, remains unknown. Data on the influence of pancreatic steatosis on microvascular complication are rare. Therefore, we investigated the relationship between pancreatic steatosis and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM).

Methods

The attenuation of three pancreatic regions (head, body, and tail) and the spleen (S) in 186 patients with T2DM was measured using non-enhanced computed tomography imaging. We used three parameters for the assessment of pancreatic steatosis (‘P’ mean: mean attenuation of three pancreatic regions; P–S: difference between ‘P’ mean and ‘S’; P/S: the ‘P’ mean to ‘S’ ratio). The presence of DR was assessed by an expert ophthalmologist using dilated fundoscopy.

Results

The average P mean was 29.02 Hounsfield units (HU), P–S was −18.20 HU, and P/S was 0.61. The three pancreatic steatosis parameters were significantly associated with the prevalence of DR in non-obese T2DM patients. In the non-obese group, the odds ratios of P mean, P–S, and P/S for the prevalence of DR, after adjustment for age, sex, and glycosylated hemoglobin level, were 2.449 (P=0.07), 2.639 (P=0.04), and 2.043 (P=0.02), respectively.

Conclusion

In this study, pancreatic steatosis was significantly associated with DR in non-obese patients with T2DM. Further studies are necessary to clarify the causal relationship between pancreatic steatosis and the development of DR.

Citations

Citations to this article as recorded by  
  • Intra‐pancreatic fat is associated with continuous glucose monitoring metrics
    Yutong Liu, Wandia Kimita, Xiatiguli Shamaitijiang, Loren Skudder‐Hill, Ivana R. Sequeira‐Bisson, Maxim S. Petrov
    Diabetes, Obesity and Metabolism.2024;[Epub]     CrossRef
  • Association between Intrapancreatic Fat Deposition and Lower High-Density Lipoprotein Cholesterol in Individuals with Newly Diagnosed T2DM
    Jianliang Wang, Qingyun Cai, Xiaojuan Wu, Jiaxuan Wang, Xiaona Chang, Xiaoyu Ding, Jia Liu, Guang Wang, Muhittin Yurekli
    International Journal of Endocrinology.2023; 2023: 1.     CrossRef
  • The comparison of pancreatic and hepatic steatosis in healthy liver donor candidates
    Bedriye Koyuncu Sokmen, Tolga Sahin, Alihan Oral, Erdem Kocak, Nagihan Inan
    Scientific Reports.2021;[Epub]     CrossRef
  • Computed Tomography-Estimated Pancreatic Steatosis is Associated with Carotid Plaque in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study from China
    Pengtao Sun, Chunzhi Fan, Rengui Wang, Tongwei Chu, Xiaoli Sun, Dongxue Zhang, Xuechao Du
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2021; Volume 14: 1329.     CrossRef
Complications
Risk Factors for the Development and Progression of Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus and Advanced Diabetic Retinopathy
Kyung-Jin Yun, Hye Ji Kim, Mee Kyoung Kim, Hyuk-Sang Kwon, Ki-Hyun Baek, Young Jung Roh, Ki-Ho Song
Diabetes Metab J. 2016;40(6):473-481.   Published online September 20, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.6.473
  • 4,324 View
  • 44 Download
  • 25 Web of Science
  • 26 Crossref
AbstractAbstract PDFPubReader   
Background

Some patients with type 2 diabetes mellitus (T2DM) do not develop diabetic kidney disease (DKD) despite the presence of advanced diabetic retinopathy (DR). We aimed to investigate the presence of DKD and its risk factors in patients with T2DM and advanced DR.

Methods

We conducted a cross-sectional study in 317 patients with T2DM and advanced DR. The phenotypes of DKD were divided into three groups according to the urine albumin/creatinine ratio (uACR, mg/g) and estimated glomerular filtration rate (eGFR, mL/min/1.73 m2): no DKD (uACR <30 and eGFR ≥60), non-severe DKD (uACR ≥30 or eGFR <60), and severe DKD (uACR ≥30 and eGFR <60). Mean systolic and diastolic blood pressure, mean glycosylated hemoglobin (HbA1c) level, and HbA1c variability (standard deviation [SD] of serial HbA1c values or HbA1c-SD) were calculated for the preceding 2 years.

Results

The prevalence of no DKD, non-severe DKD, and severe DKD was 37.2% (n=118), 37.0% (n=117), and 25.8% (n=82), respectively. HbA1c-SD and the triglyceride/high density lipoprotein cholesterol (TG/HDL-C) ratio correlated positively with uACR and negatively with eGFR. Multiple linear regression analyses showed that the HbA1c-SD and TG/HDL-C ratio were significantly related with eGFR. Multiple logistic regression analyses after adjusting for several risk factors showed that HbA1c-SD and the TG/HDL-C ratio were significant risk factors for severe DKD.

Conclusion

The prevalence of DKD was about 60% in patients with T2DM and advanced DR. HbA1c variability and TG/HDL-C ratio may affect the development and progression of DKD in these patients.

Citations

Citations to this article as recorded by  
  • Ocular and Systemic Risk Factors for Disease Worsening Among Patients with NPDR
    Charles C. Wykoff, Diana V. Do, Roger A. Goldberg, Dilsher S. Dhoot, Jennifer I. Lim, Weiming Du, Fabiana Q. Silva, Rutvi Desai, Hadi Moini, Kimberly Reed, Alyson J. Berliner, Robert Vitti, W. Lloyd Clark
    Ophthalmology Retina.2024; 8(4): 399.     CrossRef
  • Interpretable prediction model for assessing diabetes complication risks in Chinese sufferers
    Ye Shiren, Ye Jiangnan, Ye Xinhua, Ni Xinye
    Diabetes Research and Clinical Practice.2024; 209: 111560.     CrossRef
  • Dose-response association of diabetic kidney disease with routine clinical parameters in patients with type 2 diabetes mellitus: a systematic review and meta-analysis
    Jianbo Guo, Chen Liu, Yifan Wang, Baoyi Shao, Tung Leong Fong, Ngai Chung Lau, Hui Zhang, Haidi Li, Jianan Wang, Xinyu Lu, Anqi Wang, Cheuk Lung Leung, Xin Wei Chia, Fei Li, Xiaoming Meng, Qingyong He, Haiyong Chen
    eClinicalMedicine.2024; 69: 102482.     CrossRef
  • Sex-Specific Computed Tomography Abdominal Fat and Skeletal Muscle Characteristics in Type 2 Diabetic Retinopathy Patients With/Without Comorbid Diabetic Kidney Disease
    Jinlei Fan, Liping Zuo, Mingyuan Hou, Bowen Wang, Yueming An, Baoli Hao, Dexin Yu
    Academic Radiology.2023; 30(11): 2686.     CrossRef
  • The concordance and discordance of diabetic kidney disease and retinopathy in patients with type 2 diabetes mellitus: A cross-sectional study of 26,809 patients from 5 primary hospitals in China
    Zhaoxiang Liu, Xianglan Li, Yanlei Wang, Yanxia Song, Qiang Liu, Junxia Gong, Wenshuang Fan, Chunmei Lv, Chenxiang Cao, Wenhui Zhao, Jianzhong Xiao
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Ferroptosis: new insight into the mechanisms of diabetic nephropathy and retinopathy
    Luxin Li, Yucen Dai, Dan Ke, Jieting Liu, Peijian Chen, Dong Wei, Tongtong Wang, Yanjie Teng, Xiaohuan Yuan, Zhen Zhang
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Predicting diabetic kidney disease for type 2 diabetes mellitus by machine learning in the real world: a multicenter retrospective study
    Xiao zhu Liu, Minjie Duan, Hao dong Huang, Yang Zhang, Tian yu Xiang, Wu ceng Niu, Bei Zhou, Hao lin Wang, Ting ting Zhang
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
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    Xu Cao, Xiaomei Pei
    Technology and Health Care.2023; : 1.     CrossRef
  • Association between serum complements and kidney function in patients with diabetic kidney disease
    Meng-chao Liu, Jia-lin Li, Yue-fen Wang, Yuan Meng, Gui-min Zheng, Zhen Cai, Cun Shen, Meng-di Wang, Xiang-gang Zhu, Yang-zi Chen, Yu-lin Wang, Wen-jing Zhao, Wen-quan Niu, Yao-xian Wang
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Coagulation Function and Type 2 Diabetic Kidney Disease: A Real-World Observational Study
    Meng-chao Liu, Wen-quan Niu, Yue-fen Wang, Yuan Meng, Gui-min Zheng, Zhen Cai, Cun Shen, Xiang-gang Zhu, Meng-di Wang, Jia-lin Li, Wen-jing Zhao, Yao-xian Wang, Eusebio Chiefari
    Journal of Diabetes Research.2023; 2023: 1.     CrossRef
  • Punicalagin alleviates renal injury via the gut-kidney axis in high-fat diet-induced diabetic mice
    Qinglian Hua, Yaling Han, Haifeng Zhao, Haowen Zhang, Bei Yan, Shengjie Pei, Xin He, Yue Li, Xiangyuan Meng, Lei Chen, Feng Zhong, Duo Li
    Food & Function.2022; 13(2): 867.     CrossRef
  • Status and Trends of the Association Between Diabetic Nephropathy and Diabetic Retinopathy From 2000 to 2021: Bibliometric and Visual Analysis
    Wenwen Lin, Yayong Luo, Fang Liu, Hangtian Li, Qian Wang, Zheyi Dong, Xiangmei Chen
    Frontiers in Pharmacology.2022;[Epub]     CrossRef
  • The Risk Threshold for Hemoglobin A1c Associated With Albuminuria: A Population-Based Study in China
    Hong Lian, Hongshi Wu, Jie Ning, Diaozhu Lin, Chulin Huang, Feng Li, Ying Liang, Yiqin Qi, Meng Ren, Li Yan, Lili You, Mingtong Xu
    Frontiers in Endocrinology.2021;[Epub]     CrossRef
  • Weight change and microvascular outcomes in patients with new-onset diabetes: a nationwide cohort study
    Eun Sil Koh, Kyung Do Han, Mee Kyoung Kim, Eun Sook Kim, Min-Kyung Lee, Ga Eun Nam, Hyuk-Sang Kwon
    The Korean Journal of Internal Medicine.2021; 36(4): 932.     CrossRef
  • Albuminuria Is Associated with Steatosis Burden in Patients with Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease
    Eugene Han, Mi Kyung Kim, Byoung Kuk Jang, Hye Soon Kim
    Diabetes & Metabolism Journal.2021; 45(5): 698.     CrossRef
  • Effect of Calcium Dobesilate in Preventing Contrast-Induced Nephropathy in Patients with Diabetes and Chronic Kidney Disease
    Hao Zhang, Shao-Hua Guo, Zheng-Kai Xue, Ya-Ru Zhang, Jia-Rui Wang, Jing-Jin Che, Tong Liu, Hua-Yue Tao, Guang-Ping Li, Seung-Woon Rha, Swapnil-Zaman Ashraful-Haque, Kang-Yin Chen
    Clinics.2021; 76: e2942.     CrossRef
  • Elevated TG/HDL-C and non-HDL-C/HDL-C ratios predict mortality in peritoneal dialysis patients
    Wenkai Xia, Xiajuan Yao, Yan Chen, Jie Lin, Volker Vielhauer, Hong Hu
    BMC Nephrology.2020;[Epub]     CrossRef
  • Thermal Perception Abnormalities Can Predict Diabetic Kidney Disease in Type 2 Diabetes Mellitus Patients
    Wei-Ching Fang, Kuei-Mei Chou, Chiao-Yin Sun, Chin-Chan Lee, I-Wen Wu, Yung-Chang Chen, Heng-Chih Pan
    Kidney and Blood Pressure Research.2020; 45(6): 926.     CrossRef
  • Association between nonalbumin proteinuria and renal tubular damage of N-acetyl-β-d-glucosaminidase and its clinical relevance in patients with type 2 diabetes without albuminuria
    Eugene Han, Mi-Kyung Kim, Yong-ho Lee, Hye Soon Kim, Byung-Wan Lee
    Journal of Diabetes and its Complications.2019; 33(3): 255.     CrossRef
  • Detection of Lower Albuminuria Levels and Early Development of Diabetic Kidney Disease Using an Artificial Intelligence-Based Rule Extraction Approach
    Yoichi Hayashi
    Diagnostics.2019; 9(4): 133.     CrossRef
  • Therapeutic effect of liraglutide on expression of CTGF and BMP‐7 in induced diabetic nephropathy
    Maggie M. Ramzy, Ahlam M. Abdalla, Nagwa M. Zenhom, Ahmed M. Okasha, Aya E. Abdelkafy, Rabeh K. Saleh
    Journal of Cellular Biochemistry.2019; 120(10): 17512.     CrossRef
  • Are blood lipids associated with microvascular complications among type 2 diabetes mellitus patients? A cross-sectional study in Shanghai, China
    Hua Yang, Doris Young, Jian Gao, Yuanzhi Yuan, Minqian Shen, Yuan Zhang, Xueyan Duan, Shanzhu Zhu, Xiaoming Sun
    Lipids in Health and Disease.2019;[Epub]     CrossRef
  • Discordance in risk factors for the progression of diabetic retinopathy and diabetic nephropathy in patients with type 2 diabetes mellitus
    Ki‐Ho Song, Jee‐Sun Jeong, Mee Kyoung Kim, Hyuk‐Sang Kwon, Ki‐Hyun Baek, Seung‐Hyun Ko, Yu‐Bae Ahn
    Journal of Diabetes Investigation.2019; 10(3): 745.     CrossRef
  • Risk factors for the development of micro-vascular complications of type 2 diabetes in a single-centre cohort of patients
    Marsida Teliti, Giulia Cogni, Lucia Sacchi, Arianna Dagliati, Simone Marini, Valentina Tibollo, Pasquale De Cata, Riccardo Bellazzi, Luca Chiovato
    Diabetes and Vascular Disease Research.2018; 15(5): 424.     CrossRef
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    Kyung-Soo Kim, Seok Won Park, Yong-Wook Cho, Soo-Kyung Kim
    Diabetes & Metabolism Journal.2018; 42(3): 224.     CrossRef
  • Determinants of the Risk of Diabetic Kidney Disease and Diabetic Retinopathy Independent of Glucose Exposure
    Bo Kyung Koo
    Diabetes & Metabolism Journal.2016; 40(6): 444.     CrossRef

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