Field Notes

Latinos More Vulnerable to Fatty Pancreas, Type 2 Diabetes

Latinos are more likely to store fat in the pancreas and are less able to compensate by excreting additional insulin, a Cedars-Sinai study shows.

The research examining overweight, prediabetes patients, published online by Diabetes Care, is part of a focus by Cedars-Sinai’s Heart, Biomedical Imaging Research, and Diabetes and Obesity Research institutes to identify biological measures that could help predict which patients are likely to develop type 2 diabetes.

“Prevention of diabetes is our goal,” says Richard Bergman, PhD, director of the Cedars-Sinai Diabetes and Obesity Research Institute and a lead study author. “Not all people who are overweight or obese and who have insulin resistance go on to develop diabetes. If we can determine who’s most likely to develop diabetes and why, then we can make strides toward preventing it in those individuals.”

The study compared white, black, and Latino participants, similarly overweight and who shared many of the same prediabetes symptoms. It found that Latinos stored fat in their pancreas, which was less able to produce adequate amounts of insulin compared with white and black study participants. This may be why Latinos are at increased risk of developing type 2 diabetes.

In chronic obesity, the adipose tissue that’s designed to store fat begins to malfunction, allowing fat to spill into the pancreas, liver, and skeletal muscle. Some individuals may be insulin resistant throughout their lives but never develop diabetes because their pancreas can compensate by secreting more of the metabolism-regulating hormone. In others, the pancreas can’t compensate, placing these individuals at greater risk of type 2 diabetes.

“One of the reasons some people are at increased risk, we believe, is that fatty pancreas is unable to secrete enough insulin, which results in an individual progressing from impaired glucose tolerance to type 2 diabetes,” says Lidia Szczepaniak, PhD, director of magnetic resonance spectroscopy at the Cedars-Sinai Heart and Biomedical Imaging Research institutes. “In our study, we found Latinos were especially vulnerable, as they tended to store more fat in the pancreas and their compensatory insulin secretion was entirely suppressed.”

The research, for which Szczepaniak was principal investigator, included the use of a noninvasive medical imaging technique, known as magnetic resonance spectroscopy, to measure the amount of fat in organs.

In the study, Latino, black, and white adults completed three research visits, including an oral glucose tolerance test, a frequently sampled IV glucose tolerance test to evaluate beta-cell function and insulin resistance, and magnetic resonance spectroscopy to evaluate fat levels in the pancreas and liver.

— Source: Cedars-Sinai Medical Center


Levels of BPA in Children, Teens Associated With Obesity

Researchers at New York University School of Medicine have revealed a significant association between obesity and children and adolescents with higher concentrations of urinary bisphenol A (BPA). The study appears in The Journal of the American Medical Association.

“This is the first association of an environmental chemical in childhood obesity in a large, nationally representative sample,” says lead investigator Leonardo Trasande, MD, MPP, an associate professor of pediatrics and environmental medicine. “Our findings further demonstrate the need for a broader paradigm in the way we think about the obesity epidemic. Unhealthy diet and lack of physical activity certainly contribute to increased fat mass, but the story clearly doesn’t end there.”

BPA, a low-grade estrogen, was until recently found in plastic bottles labeled with the No. 7 recycling symbol and is still used as an internal coating for aluminum cans. Manufacturers say it provides an antiseptic function, but studies have shown the chemical disrupts multiple mechanisms of human metabolism that may increase body mass. BPA exposure also has been associated with cardiovascular disease, breast cancer, prostate cancer, neurological disorders, diabetes, and infertility.

“In the U.S. population, exposure [to BPA] is nearly ubiquitous, with 92.6 percent of persons 6 years or older identified in the 2003-2004 National Health and Nutrition Examination Survey (NHANES) as having detectable BPA levels in their urine. A comprehensive, cross-sectional study of dust, indoor and outdoor air, and solid and liquid food in preschool-aged children suggested that dietary sources constitute 99 percent of BPA exposure,” the investigators wrote.

Using a sample of nearly 3,000 children and adolescents aged 6 to 19 randomly selected for measurement of urinary BPA concentration in the 2003-2008 NHANES, researchers examined associations between urinary BPA concentrations and body mass.

After controlling for race/ethnicity, age, caregiver education, poverty-to-income ratio, sex, serum cotinine level, caloric intake, television watching, and urinary creatinine level, the researchers found children with the highest levels of urinary BPA had 2.6 times higher odds of being obese than those with the lowest measures of urinary BPA. Among the participants with the highest levels, 22.3% were obese compared with 10.3% of the participants with the lowest levels.

Further analyses showed this association to be statistically significant in only one racial subpopulation: white children and adolescents. The researchers also found that obesity was not associated with exposure to other environmental phenols commonly used in other consumer products, such as sunscreens and soaps.

“Most people agree the majority of BPA exposure in the United States comes from aluminum cans,” Trasande says. “This data adds to already existing concerns about BPA and further supports the call to limit exposure of BPA in this country, especially in children. Removing it from aluminum cans is probably one of the best ways we can limit exposure. There are alternatives that manufacturers can use to line aluminum cans.”

— Source: New York University Langone Medical Center