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Higher Islet Amyloid Load in Men Than in Women With Type 2 Diabetes Mellitus

Zhao, Hai-Lu PhD, MD*; Sui, Yi MD*; Guan, Jing MD*; He, Lan MD*; Lai, Fernand M.M. MD; Zhong, Ding-Rong MD; Yang, Di MD§; Baum, Larry PhD*; Tong, Peter C.Y. PhD*; Tomlinson, Brian MD*; Chan, Juliana C.N. MD*

doi: 10.1097/MPA.0b013e3181788e18
Online Articles: Original Article
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Objectives: Type 2 diabetes mellitus is characterized histopathologically by islet amyloid deposits formed from islet amyloid polypeptide. The aim of this study was to investigate sex difference in islet amyloid of type 2 diabetic patients.

Methods: Pancreas specimens were collected from 235 autopsies with type 2 diabetes mellitus. Islet amyloid was identified with Congo red stain. The load of islet amyloid deposits was assessed by prevalence (percentage of cases with islet amyloid deposits), frequency (percentage of islets containing amyloid deposits), and severity (percentage of islet area occupied by amyloid deposits).

Results: Women (n = 80) and men (n = 155) had similar age of death, duration of diabetes, body mass index, and hemoglobin (Hb)A1c level. Islet amyloid was found in 30.0% of the women and in 44.5% of the men (P = 0.035). None of 9 women younger than 50 years had islet amyloid. Frequency of amyloid-affected islets was 31.5% ± 13.1% in women and 41.1% ± 14.3% in men (P = 0.008). Severity of amyloid-affected islet area was 29.0% ± 12.5% in women and 38.5% ± 14.6% in men (P = 0.007).

Conclusions: Sex is a determinant of the development of islet amyloid in type 2 diabetes mellitus. This sex difference in islet amyloid may be related to a potential benefit of female sex hormones.

From the Departments of *Medicine and Therapeutics and †Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong; ‡Department of Pathology, Chinese PLA General Hospital; and §Department of Pathology, Peking Union Medical College Hospital, Beijing, China.

Received for publication August 2, 2007; accepted April 2, 2008.

The authors Lai and Zhong contributed equally to this study.

This study was supported by grants from the Graduate School of the Chinese University of Hong Kong and the Hong Kong Research Grants Council (CUHK4462/06M).

Reprints: Hai-Lu Zhao, PhD, Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong (e-mail: zhaohailu@cuhk.edu.hk).

© 2008 Lippincott Williams & Wilkins, Inc.