title: Novel phenotypes of prediabetes?
abstract: This article describes phenotypes observed in a prediabetic population (i.e. a population with increased risk for type 2 diabetes) from data collected at the University hospital of Tübingen. We discuss the impact of genetic variation on insulin secretion, in particular the effect on compensatory hypersecretion, and the incretin-resistant phenotype of carriers of the gene variant TCF7L2 is described. Imaging studies used to characterise subphenotypes of fat distribution, metabolically healthy obesity and metabolically unhealthy obesity are described. Also discussed are ectopic fat stores in liver and pancreas that determine the phenotype of metabolically healthy and unhealthy fatty liver and the recently recognised phenotype of fatty pancreas. The metabolic impact of perivascular adipose tissue and pancreatic fat is discussed. The role of hepatokines, particularly that of fetuin-A, in the crosstalk between these organs is described. Finally, the role of brain insulin resistance in the development of the different prediabetes phenotypes is discussed.
authors.affiliation: Department of Internal Medicine IV, Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany. Hans-Ulrich.Haering@med.uni-tuebingen.de.|Institute of Diabetes Research and Metabolic Diseases (IDM), University of Tübingen, Tübingen, Germany. Hans-Ulrich.Haering@med.uni-tuebingen.de.|German Center for Diabetes Research (DZD), Neuherberg, Germany. Hans-Ulrich.Haering@med.uni-tuebingen.de.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Häring
mesh_terms: D000818:Animals; D001921:Brain / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance / Q000502:physiology; D010641:Phenotype; D011236:Prediabetic State / Q000378:metabolism* / Q000473:pathology
chemical_list: D007328:Insulin
keywords: Brain insulin resistance; Insulin; Liver fat; Phenotype; Prediabetes; Review; Secretion; Sensitivity