Diabet Med. 2023 Apr 10:e15111. doi: 10.1111/dme.15111. Online ahead of print.
ABSTRACT
OBJECTIVES: To investigate whether manganese-enhanced magnetic resonance imaging can assess functional pancreatic beta-cell mass in people with type 1 diabetes mellitus.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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 the investigating type 1 diabetes, monitoring disease progression and assessing novel immunomodulatory interventions.
PMID:37035965 | DOI:10.1111/dme.15111
