The pancreatic -cells are responsible for the maintenance of the body's glucose levels within a very narrow range; their population is dynamic and undergoes compensatory changes to maintain euglycemia. The structural parameters that allow mass changes (replication, neogenesis, cell volume changes, and cell death) can now be assessed and have proved to be powerful tools. Changes in one parameter can dramatically affect the -cell mass. Unfortunately, conclusions are often drawn on measurements that do not assess -cell mass but only relative volumes. Throughout the lifetime of a mammal, low levels of -cell replication and apoptosis are balanced and result in a slowly increasing mass. The balance allows gradual replacement of the -cell population; thus, -cells should be considered a slowly renewed tissue. Two major implications of -cell turnover are that 1) at any time, the -cells would be at different ages and 2) any limitation on replacement could have dire consequences for glucose homeostasis. Diabetes 50 (Suppl. 1):S20-S24, 2001 T he evidence that the -cell mass exists in a dynamic state is becoming increasingly strong. Accumulated experimental data from rodents show that -cells change in mass and function to maintain plasma glucose levels in a very narrow range. The structural parameters that allow mass changes (replication, neogenesis, cell volume changes, and cell death) have been recognized for many years, but only in the last decade have integrated analyses of these parameters been done. From these studies, several concepts have emerged:• There is growth of the -cell mass throughout the life span.• There is continued renewal and loss, that is, turnover, of -cells.• There exist additional compensatory changes to maintain glucose homeostasis. This perspective will address the basis of these concepts, address the assessment of the components that regulate -cell mass and turnover, and discuss the implications of having a slowly renewed and ever-expanding -cell mass.
ASSESSMENT TOOLS FOR -CELL TURNOVERTo be able to document -cell turnover, there are a number of parameters one must quantitate: -cell mass, -cell number, and -cell replication. Two other parameters, -cell neogenesis and -cell apoptosis, can be documented for frequency, but rates for these cannot as yet be measured.The assessment of -cell mass has proved to be a powerful tool. Unfortunately, often conclusions have been drawn on measurements that do not assess -cell mass but only relative volumes. To estimate -cell mass, one must have the pancreatic weight as well as quantitate the relative volume (also called relative density, volume density, or percentage of pancreatic tissue) of the -cells. The pancreatic weight can be equated with pancreatic volume or mass if one makes the reasonable assumption that 1 cm 3 tissue weighs 1 g. With data for relative volume and pancreatic weight, one can estimate the absolute weight or mass of the -cells (Fig. 1). Many different methods for quantitating the relative volume of a tissue exi...