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      Effects of Glucocorticoid Treatment on β- and α-Cell Mass in Japanese Adults With and Without Diabetes.

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          Abstract

          The aim of this study was 1) to clarify β-cell regenerative capacity in the face of glucocorticoid (GC)-induced insulin resistance and 2) to clarify the change in β- and α-cell mass in GC-induced diabetes in humans. We obtained the pancreases from 100 Japanese autopsy case subjects. The case subjects were classified according to whether or not they had received GC therapy before death and the presence or absence of diabetes. Fractional β-cell area (%BCA) and α-cell area (%ACA) were quantified, and the relationship with GC therapy was evaluated. As a result, in case subjects without diabetes, there was no significant difference in %BCA between case subjects with and without GC therapy (1.66 ± 1.05% vs. 1.21 ± 0.59%, P = 0.13). %ACA was also not significantly different between the two groups. In case subjects with type 2 diabetes, %BCA and %ACA were both significantly reduced compared with control subjects without diabetes; however, neither %BCA nor %ACA was significantly decreased in case subjects with GC-induced diabetes. There was a significant negative correlation between %BCA and HbA1c measured before death; however, this relationship was attenuated in case subjects with GC therapy. In conclusion, the current study suggests that β- and α-cell mass remain largely unchanged in the face of GC-induced insulin resistance in Japanese individuals, implying limited capacity of β-cell regeneration in adult humans. The absence of apparent β-cell deficit in case subjects with GC-induced diabetes suggests that GC-induced diabetes is mainly caused by insulin resistance and/or β-cell dysfunction, but not necessarily a deficit of β-cell mass.

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          Author and article information

          Journal
          Diabetes
          Diabetes
          American Diabetes Association
          1939-327X
          0012-1797
          Aug 2015
          : 64
          : 8
          Affiliations
          [1 ] Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
          [2 ] Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan ysaisho@keio.jp.
          [3 ] Department of Pathology, Keio University School of Medicine, Tokyo, Japan.
          Article
          db15-0151
          10.2337/db15-0151
          25883114
          ff8763fd-399a-45fb-88a8-7eae6359aa01
          History

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