Pancreatic beta cell/islet mass and body mass index.

Body mass index (BMI) is widely used to define obesity. In studies of pancreatic beta-cell/islet mass, BMI is also a common standard for matching control subjects in comparative studies along with age and sex, based on the existing dogma of their significant positive correlation reported in the literature. We aimed to test the feasibility of BMI and BSA to assess obesity and predict beta-cell/islet mass. We used National Health and Nutrition Examination Survey (NHANES) data that provided dual-energy Xray absorptiometry (DXA)-measured fat mass (percent body fat; %BF), BMI, and BSA for adult subjects (20-75y; 4,879 males and 4,953 females). We then analyzed 152 cases of islet isolation performed at our center for correlation between islet yields and various donor anthropometric indices. From NHANES, over 50% of male subjects and 60% of female subjects with BMI:20.1-28.1 were obese as defined by %BF, indicating a poor correlation between BMI and %BF. BSA was also a poor indicator of %BF, as broad overlap was observed in different BSA ranges. Additionally, BMI and BSA ranges markedly varied between sex and race/ethnicity groups. From islet isolation, BMI and BSA accounted for only a small proportion of variance in islet equivalent (IEQ; r2 = 0.09 and 0.11, respectively). BMI and obesity were strongly correlated in cases of high BMI subjects. However, the critical populations were non-obese subjects with BMI ranging from 20.1-28.1, in which a substantial proportion of individuals may carry excess body fat. Correlations between BMI, BSA, pancreas weight and beta-cell/islet mass were low.

Three-Dimensional Analysis of the Human Pancreas.

Pancreatic islets are endocrine micro-organs scattered throughout the exocrine pancreas. Islets are surrounded by a network of vasculature, ducts, neurons, and extracellular matrix. Three-dimensional imaging is critical for such structural analyses. We have adapted transparent tissue tomography to develop a method to image thick pancreatic tissue slices (1 mm) with multifluorescent channels. This method takes only 2 to 3 days from specimen preparation and immunohistochemical staining to clearing tissues and imaging. Reconstruction of the intact pancreas visualizes islets with ß, α, and δ cells together with their surrounding networks. Capturing several hundred islets at once ensures sufficient power for statistical analyses. Further surface rendering provides clear views of the anatomical relationship between islets and their microenvironment as well as the basis for volumetric quantification. As a proof-of-principle demonstration, we show an islet size-dependent increase of intraislet capillary density and an inverse decrease in sphericity.

Quantitative analysis of intra- and inter-individual variability of human beta-cell mass.

Pancreatic beta-cell mass is a critical determinant of the progression of diabetes. The loss of beta-cells in various types of diabetes has been documented in comparison to age, sex and body mass index (BMI) matched control subjects. However, the underlying heterogeneity of beta-cell mass in healthy individuals has not been considered. In this study, the inter-individual heterogeneity in beta-cell/islet mass was examined among 10 cases of age-matched non-diabetic male subjects in relation to BMI, pancreas weight, and the percent ratio, volume and number of islets in the whole pancreas. Beta-cell/islet mass was measured using a large-scale unbiased quantification method. In contrast to previous studies, we found no clinically relevant correlation between beta-cell/islet mass and age, BMI or pancreas weight, with large differences in beta-cell/islet mass and islet number among the individuals. Our method extracts the comprehensive information out of individual pancreas providing multifaceted parameters to study the intrinsic heterogeneity of the human pancreas.