Article

Diabetologia

, Volume 53, Issue 10, pp 2167-2176

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Adaptive changes in pancreatic beta cell fractional area and beta cell turnover in human pregnancy

  • A. E. ButlerAffiliated withLarry L. Hillblom Islet Research Center, UCLA David Geffen School of Medicine
  • , L. Cao-MinhAffiliated withLarry L. Hillblom Islet Research Center, UCLA David Geffen School of Medicine
  • , R. GalassoAffiliated withLarry L. Hillblom Islet Research Center, UCLA David Geffen School of Medicine
  • , R. A. RizzaAffiliated withEndocrine Research Unit, Department of Medicine, Mayo Clinic and Medical School
  • , A. CorradinAffiliated withDepartment of Information Engineering, University of Padua
  • , C. CobelliAffiliated withDepartment of Information Engineering, University of Padua
  • , P. C. ButlerAffiliated withLarry L. Hillblom Islet Research Center, UCLA David Geffen School of Medicine Email author 

Abstract

Aims/hypothesis

We sought to establish the extent and basis for adaptive changes in beta cell numbers in human pregnancy.

Methods

Pancreas was obtained at autopsy from women who had died while pregnant (n = 18), post-partum (n = 6) or were not pregnant at or shortly before death (controls; n = 20). Pancreases were evaluated for fractional pancreatic beta cell area, islet size and islet fraction of beta cells, beta cell replication (Ki67) and apoptosis (TUNEL), and indirect markers of beta cell neogenesis (insulin-positive cells in ducts and scattered beta cells in pancreas).

Results

The pancreatic fractional beta cell area was increased by ∼1.4-fold in human pregnancy, with no change in mean beta cell size. In pregnancy there were more small islets rather than an increase in islet size or beta cells per islet. No increase in beta cell replication or change in beta cell apoptosis was detected, but duct cells positive for insulin and scattered beta cells were increased with pregnancy.

Conclusions/interpretation

The adaptive increase in beta cell numbers in human pregnancy is not as great as in most reports in rodents. This increase in humans is achieved by increased numbers of beta cells in apparently new small islets, rather than duplication of beta cells in existing islets, which is characteristic of pregnancy in rodents.

Keywords

Human Islet Pancreas Pregnancy