Having higher levels of fat in the liver, and having a smaller pancreas directly increase the risk of developing type 2 diabetes, according to a new study.
This research, published in the journal Diabetes Care could unlock new treatment approaches and allow more tailored ways to help people reduce their risk of type 2 diabetes, as well as preventing cases altogether. The findings provide a significant step forward in understanding the biological causes driving the development of the condition.
Researchers, funded by Diabetes UK and led by Diabetes UK RD Lawrence Fellow Dr Hanieh Yaghootkar, at Brunel University, analysed data from 32,859 people who had had MRI scans as part of the UK Biobank study. Liver and pancreas fat and size from these scans were analysed alongside information about genes that affect these factors, to understand their causal role in the risk of developing diabetes.
They found that people with a genetic make-up that makes them prone to storing fat in their liver are more likely to have type 2 diabetes. This indicates that higher liver fat levels directly increase the risk of type 2 diabetes, with analysis showing that for every 5% increase in liver fat, risk of type 2 diabetes increases by 27%. Similarly, having a smaller pancreas was found to have a direct role in causing type 2 diabetes.
Non-alcoholic fatty liver disease (NAFLD) occurs when fat builds up in the liver. NAFLD is most commonly seen in people living with obesity or overweight, and having higher levels liver fat has previously been associated with development of type 2 diabetes. However, this is the strongest evidence to date to suggest liver fat and pancreas size have a role in causing the condition.
Previous research has shown that losing weight can reduce liver fat levels in people with type 2 diabetes. Piecing together how different factors impact the risk of developing type 2 diabetes is important in understanding the most effective ways to help people reduce their risk. In future, those with a certain genetic makeup that may make them prone to higher liver fat levels or a smaller pancreas, could be offered tailored support to help them take steps to reduce their risk of type 2 diabetes early on.
Dr Yaghootkar said: ‘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.
‘Our results encourage better treatment for those living with NAFLD, and provide evidence for the multiple benefits of weight loss and better screening for diabetes risk in these people.’
Martin S, et al. Diabetes Care Dec 2021; dc 211262