8066 Compensatory Signatures of Islet Cells That Protect Obese Humans From Diabetes

Abstract Disclosure: H. Kim: None. Y. Li: None. H. Zhu: None. K. El Jellas: None. N. Shukla: None. Z. Ren: None. K. Fukuda: None. M. Chen: None. R. Kulkarni: Advisory Board Member; Self; Novo Nordisk, Inversago, Biomea, REDD. The increasing prevalence of obesity and type 2 diabetes (T2D) continues to be a major global socioeconomic burden. Healthy humans adapt to metabolic stress by increasing their functional β-cell mass. Failure of this process, called decompensation, potentially triggers the development of T2D in many but not all obese humans. Furthermore, the molecular mechanism(s) underlying the ability of heterogeneous human β-cells to compensate and protect obese humans from developing T2D remain elusive. Here we report unique gene signatures of β-cell subtypes and their molecular interactions with islet stellate cells during successful compensation in human obesity. Using a single-nucleus multiomics approach, we profiled gene expression and chromatin accessibility of 160,954 islet nuclei from non-diabetic lean, overweight, obese, or T2D human donors. We identified multiple β-cell subtypes and their unique sets of genes, biological pathways, and transcription factors associated with compensation. The genome-wide association studies corroborated the compensatory genes identified in the subsets, showing significant associations with metabolic phenotypes in humans. Unbiased cell-cycle gene and ligand-receptor analyses of islet cell types revealed that activated stellate cells proliferate and interact with the β-cell subtypes that involves the extracellular matrix-integrin protein complex in non-diabetic obesity. These results highlight the physiological roles of islet stellate cells in regulating β-cell compensation and point to therapeutic opportunities in precision medicine to protect obese humans from developing T2D. Presentation: 6/3/2024