The relation of islet amyloid to the clinical type of diabetes

doi:10.1016/S0046-8177(81)80197-9

Human Pathology

Volume 12, Issue 10, October 1981, Pages 917-922

https://doi.org/10.1016/S0046-8177(81)80197-9 Get rights and content

Abstract

Islets were evaluated for the presence of amyloid deposits in 169 pancreases removed at autopsy. Islet amyloid occurred in 17 of 142 (12 per cent) of nondiabetics and in 16 of 27 (59 per cent) of diabetics. When diabetics were divided into categories according to clinical severity of disease, the insulin treated diabetics had the highest prevalence (89 per cent), the most diffuse distribution, and the most severe degree of islet amyloidosis. Amyloid was not found in any pancreases from subjects under 40 years of age. Above the age of 40, there was no correlation between aging and prevalence of islet amyloid. There was a significant association between severity of diabetes and prevalence of islet amyloid. The low prevalence of amyloid seen in nondiabetics and the fact that all adult onset, insulin treated diabetics had islet amyloid indicate that a reaction to endogenous insulin may be the basis for the deposition of islet amyloid.

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These amyloid deposits were first named islet amyloid because of its location inside the islets of Langerhans and later found to consist of the polypeptide hormone, islet amyloid polypeptide (IAPP) (1), which is expressed by the β-cell and co-secreted together with insulin (2, 3). A reduction in β-cell number is observed in patients with T2D (4), and the severity of the disease has been suggested to correlate with the amount of IAPP amyloid (5–7). IAPP fibrils are made of several interacting protofilaments.
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^*: This work was supported by grant CA 19410 from the National Cancer Institute through the National Pancreatic Cancer Project.

^*: Medical Student, Dartmouth Medical School, Hanover, New Hampshire.

^†: Professor of Pathology, Department of Pathology, Dartmouth Medical School. Attending Staff, Mary Hitchcock Afemorial Hospital, Hanover, New Hampshire.

^‡: Assistant Professor, Departments of Medicine and Community and Family Medicine, Dartmouth Medical School. Attending Staff, Mary Hitchcock Memorial Hospital, Hanover, New Hampshire.

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The relation of islet amyloid to the clinical type of diabetes*

Abstract

Beitr. Path.

The relation of diabetes mellitus to lesions of the pancreas. Hyaline degeneration of the islets of Langerhans

J. Exper. Med.

Hyalinization of the islets of Langerhans in diabetes mellitus

Diabetes

Amyloidosis of the islets of Langerhans: a restudy of islet hyalin in diabetic and nondiabetic individuals

Am. J. Pathol.

Antibody to cultured human insulinoma cells in insulin-dependent diabetes

Lancet

VAriation with age and diseae of an amyloid A protein-related serum component

J. Clin. Invest.

On the nature of the amyloid in human islets of Langerhans

Histochemistry

ß-pleated sheet fibrils: a comparison of native amyloid with synthetic protein fibrils

J. Histochem. Cytochem.

Amyloidosis of the pancreas: histochemical differentiation between insular and extrainsular deposits

Basic Appl. Histochem.