ArticleDiabetologia2025
Quantitative analysis of human adult pancreatic histology reveals separate fatty and fibrotic phenotypes in type 2 diabetes.
Article in Diabetologia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Burden of Intrapancreatic Fat Deposition in Type 2 Diabetes and the Role of Obesity: A Systematic Review and Meta-Analysis.Current obesity reports · 2026Pooled it
- Intrapancreatic fat deposition shows distinct regional and compartmental associations with obesity and diabetes.iScience · 2026Article
- Review
- Review
- Activation of the Pancreatic "Metabolic Synapse" Aggravates Type 2 Diabetes Mellitus by Inducing PANoptosis in β-Cells.Diabetes · 2026Article
- Antidiabetic Effect of Substituting Processed Meat with Reduced-Fat and Diatomaceous Earth-Enriched Pâtés in Middle-Aged Female Wistar Rats.Foods (Basel, Switzerland) · 2026Article
- Article
- The Fatty Pancreas: Current Evidence, Treatment Implications, and Future Directions.Gastro hep advances · 2026Review
- Evaluation of distinct and similar pathological features between diabetes and Alzheimer's disease.EXCLI journal · 2026Review
- Systemic effects of type 2 diabetes therapies: an integrated perspective on the cardio-renal- cerebral-metabolic axis.Frontiers in medicine · 2026Review
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Authors and funding
10 authors.
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Abstract
aims/hypothesisThe role of intra-pancreatic lipid and collagen in type 2 diabetes pathogenesis remains unclear. We sought to examine this in pancreases from organ donors with and without diabetes.
methodsTissue biopsies from 36 adult donor pancreases with/without type 2 diabetes were collected from 16 anatomically defined regions, with H&E, Sirius Red Fast Green and chromogranin A immunohistochemical staining and quantification performed. Intracellular lipid droplet area was quantified using transmission electron microscopy in acinar, islet endocrine, beta and alpha cells identified through ultrastructural morphology.
resultsIncreasing adipocyte proportional area was associated with increasing pancreas donor BMI (r=0.385, p=0.021), decreased acinar area (r=-0.762, p<0.001) and increased endocrine mass (r=0.749, p<0.001). Fibrosis was not associated with BMI, acinar area or endocrine mass. Type 2 diabetes was associated with decreased islet circularity and reduced beta:alpha cell ratio but endocrine mass was not affected. Adipocyte and fibrosis proportional areas were highest in donors with diabetes but not associated with each other. Pancreases with high fat and those with high fibrosis (>40% proportional area) appeared to form two separate subgroups. All donors with insulin-treated diabetes had a high collagen proportional area. Fibrosis but not adipocytosis was associated with decreased beta:alpha cell ratio. There was an inverse relationship between pancreatic adipocytosis and intra-acinar cell lipid content (r=-0.490, p=0.003), with the lowest levels seen in type 2 diabetes. Beta cell lipid content was associated with BMI but not type 2 diabetes. CONCLUSIONS/
interpretationSystematic human pancreatic analysis revealed two separate type 2 diabetes phenotypes: fatty, associated with central obesity; and fibrotic, associated with reduced beta cell mass without central obesity. This suggests distinct underlying pathogenic mechanisms and has potential for developing personalised disease-modifying therapeutics.
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