Jia Jiet Lim, Ivana R Sequeira-Bisson, Wilson C Y Yip, Louise W Lu, Jennifer L Miles-Chan, Sally D Poppitt
Journal: Diabetes research and clinical practice 2024;207():111084
PMID: 38154534
Dietary protein may play a unique role in maintaining glucose homeostasis. Whey protein has been proposed to improve postprandial glycaemia in the prevention and treatment of type-2 diabetes. This observational study aimed to investigate the association of intra-pancreatic fat deposition (IPFD) on markers of pancreatic cell function after using whey protein. Twenty-four women living with overweight, who had impaired fasting glucose (IFG) were enrolled and randomised. They underwent magnetic resonance imaging and spectroscopy (MRI/S) in a fasted state, to assess intra-pancreatic and intra-hepatic fat deposition. The study was a 3-arm single-blind, cross-over trial with all participants trialing 3g of whey protein, a low dose whey protein 12.5 g, a high-dose whey protein 50g and a water control, with a seven day wash out period. The results found the women with high intra-pancreatic fat deposition had higher circulating levels of two pancreatic hormones following an oral load of whey protein: glucagon-like peptide-1 (GLP-1); and glucagon. No impact was seen on insulin secretion. The authors conclude that the observations may help to explain the variability of the glucagon-like peptide-1 response in a population with pre-diabetes. The cause for elevated blood glucose is multifactorial and the differences could also be from adaptive responses. Moreover, further investigations are required to translate the findings to a mixed gender population with different glycaemic status.
AIM
Intra-pancreatic fat deposition (IPFD) while hypothesised to impair beta-cell function, its impact on alpha-cells remains unclear. We evaluated the association between IPFD and markers of pancreatic cells function using whey protein.
METHODS
Twenty overweight women with impaired fasting glucose (IFG) and low or high IPFD (<4.66% vs ≥4.66%) consumed 3 beverage treatments: 0 g (water control), 12.5 g (low-dose) and 50.0 g (high-dose) whey protein, after an overnight fast, in randomised order. Blood glucose, insulin, C-peptide, glucagon, gastric-inhibitory polypeptide (GIP), glucagon-like peptide-1 (GLP-1) and amylin were analysed postprandially over 4 h. Incremental area-under-the-curve (iAUC), incremental maximum concentration (iCmax), and time to maximum concentration (Tmax) for these were compared between IPFD groups using repeated measures linear mixed models, also controlled for age (p).
RESULTS
iAUC and iCmax glucose and insulin while similar between the two IPFD groups, high IPFD and ageing contributed to higher postprandial glucagon (iAUC: p = 0.012; p = 0.004; iCmax: p = 0.069; p = 0.021) and GLP-1 (iAUC: p = 0.006; p = 0.064; iCmax: p = 0.011; p = 0.122) concentrations.
CONCLUSION
In our cohort, there was no evidence that IPFD impaired protein-induced insulin secretion. Conversely, IPFD may be associated with increased protein-induced glucagon secretion, a novel observation which warrants further investigation into its relevance in the pathogenesis of dysglycaemia and type-2 diabetes.
Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.
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