Metabolic traits affecting the relationship between liver fat and intrapancreatic fat: a mediation analysis

Juyeon Ko; Ivana R Sequeira; Loren Skudder-Hill; Jaelim Cho; Sally D Poppitt; Maxim S Petrov

doi:10.1007/s00125-022-05793-4

Metabolic traits affecting the relationship between liver fat and intrapancreatic fat: a mediation analysis

Diabetologia. 2023 Jan;66(1):190-200. doi: 10.1007/s00125-022-05793-4. Epub 2022 Oct 4.

Authors

Juyeon Ko¹, Ivana R Sequeira^{2

3}, Loren Skudder-Hill¹, Jaelim Cho¹, Sally D Poppitt^{1

2

3

4}, Maxim S Petrov⁵

Affiliations

¹ School of Medicine, University of Auckland, Auckland, New Zealand.
² Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand.
³ High Value Nutrition, National Science Challenge, Auckland, New Zealand.
⁴ Riddet Centre of Research Excellence for Food and Nutrition, Palmerston North, New Zealand.
⁵ School of Medicine, University of Auckland, Auckland, New Zealand. m.petrov@auckland.ac.nz.

Abstract

Aims/hypothesis: The clinical importance of fat deposition in the liver and pancreas is increasingly recognised. However, to what extent deposition of fat in these two depots is affected by intermediate variables is unknown. The aim of this work was to conduct a mediation analysis with a view to uncovering the metabolic traits that underlie the relationship between liver fat and intrapancreatic fat deposition (IPFD) and quantifying their effect.

Methods: All participants underwent MRI/magnetic resonance spectroscopy on the same 3.0 T scanner to determine liver fat and IPFD. IPFD of all participants was quantified manually by two independent raters in duplicate. A total of 16 metabolic traits (representing markers of glucose metabolism, incretins, lipid panel, liver enzymes, pancreatic hormones and their derivatives) were measured in blood. Mediation analysis was conducted, taking into account age, sex, ethnicity and BMI. Significance of mediation was tested by computing bias-corrected bootstrap CIs with 5000 repetitions.

Results: A total of 353 individuals were studied. Plasma glucose, HDL-cholesterol and triacylglycerol mediated 6.8%, 17.9% and 24.3%, respectively, of the association between liver fat and IPFD. Total cholesterol, LDL-cholesterol, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, γ-glutamyl transpeptidase, insulin, glucagon, amylin, C-peptide, HbA_1c, glucagon-like peptide-1 and gastric inhibitory peptide did not mediate the association between liver fat and IPFD.

Conclusions/interpretation: At least one-quarter of the association between liver fat and IPFD is mediated by specific blood biomarkers (triacylglycerol, HDL-cholesterol and glucose), after accounting for potential confounding by age, sex, ethnicity and BMI. This unveils the complexity of the association between the two fat depots and presents specific targets for intervention.

Keywords: Glucose metabolism; Incretins; Intrapancreatic fat; Lipids; Liver enzymes; Liver fat; Mediation; Pancreatic hormones.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cholesterol
Humans
Liver*
Mediation Analysis*

Substances

Cholesterol