A prospective evaluation of fatty pancreas by using EUS

Sepe, Paul S.; Ohri, Ashray; Sanaka, Sirish; Berzin, Tyler M.; Sekhon, Sandeep; Bennett, Gayle; Mehta, Gaurav; Chuttani, Ram; Kane, Robert A.; Pleskow, Douglas K.; Sawhney, Mandeep S.

doi:10.1016/j.gie.2011.01.015

Cited by 134 publications

(189 citation statements)

References 20 publications

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“…Studies on fatty pancreas have been hampered by the lack of appropriate investigational tools. In a study of 230 patients referred for endoscopic ultrasound examination, 64 (27.8 % ) were found to have fatty pancreas ( 30 ). Although endoscopic ultrasonography allows close access to the pancreas, it is not an ideal method as it is invasive, operator-dependent, unable to quantitate the entire fat content of the pancreas, and is performed in patients with metabolic and other abnormalities.…”

Section: Fatty Pancreas and Insulin Resistancementioning

confidence: 99%

Fatty Pancreas, Insulin Resistance, and β-Cell Function: A Population Study Using Fat-Water Magnetic Resonance Imaging

Wong

Yeung

et al. 2014

American Journal of Gastroenterology

203

178

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OBJECTIVES:Nonalcoholic fatty liver disease is the most common chronic liver disease. Fatty pancreas has also been described but is diffi cult to assess. It is now possible to measure pancreatic and liver fat accurately with magnetic resonance imaging (MRI). We aimed to defi ne the normal range of pancreatic fat and identify factors associated with fatty pancreas. In addition, the effect of fatty liver and fatty pancreas on insulin resistance (IR) and pancreatic ␤ -cell function was studied. METHODS:Fat-water MRI and proton-magnetic resonance spectroscopy were performed on 685 healthy volunteers from the general population to measure pancreatic and liver fat, respectively. On the basis of fasting plasma glucose and insulin levels, the IR and ␤ -cell function were assessed using the homeostasis model assessment (HOMA). RESULTS:Among subjects without signifi cant alcohol consumption or any component of metabolic syndrome, 90 % had pancreatic fat between 1.8 and 10.4 % . Using the upper limit of normal of 10.4 % , 110 (16.1 % ; 95 % confi dence interval 13.3 -18.8 % ) subjects had fatty pancreas. On multivariable analysis, high serum ferritin, central obesity, and hypertriglyceridemia were independent factors associated with fatty pancreas. Subjects with both fatty pancreas and fatty liver had higher HOMA-IR than did those with either condition alone. Fatty pancreas was not associated with HOMA-β after adjusting for liver fat and body mass index.CONCLUSIONS: In all, 16.1 % of this community cohort of adult Hong Kong Chinese volunteers had a fatty pancreas by our defi nition. Central obesity, hypertriglyceridemia, and hyperferritinemia are associated with fatty pancreas. Individuals with fatty pancreas have increased IR.

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Section: Fatty Pancreas and Insulin Resistancementioning

confidence: 99%

Fatty Pancreas, Insulin Resistance, and β-Cell Function: A Population Study Using Fat-Water Magnetic Resonance Imaging

Wong

Yeung

et al. 2014

American Journal of Gastroenterology

203

178

View full text Add to dashboard Cite

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“…We suspected that the changes in pancreatic texture associated with "metabolic syndrome," known as fatty pancreas, may also be associated with higher rates of POPF after radical gastrectomy. Fatty infiltration to the pancreas is reportedly similar to that of the liver [10,11] , being characterized by a softness in the texture of the pancreas [12] . We assumed that this fatty change in the pancreas could obscure the contour of pancreas during peripancreatic lymphadenectomy and thus it may be associated with an increased rate of POPF after radical gastrectomy.…”

mentioning

confidence: 99%

Risk Factor of Pancreatic Fistula after Radical Gastrectomy from the Viewpoint of Fatty Pancreas

Sato¹,

Inokuchi²,

Otsuki³

et al. 2017

Dig Surg

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Background: We suspected that fatty pancreas, accompanied with metabolic syndrome, may be associated with the incidence of postoperative pancreatic fistula (POPF) after radial gastrectomy. Methods: Between February 2012 and March 2014, we reviewed consecutive 79 gastric cancer patients who underwent radical gastrectomy. To quantify the degree of fatty infiltration to pancreas by preoperative contrast-enhanced CT, we measured ratios and differences between pancreatic and splenic attenuation values (P/S and P-S, respectively). The optimal cut-off values of P/S and P-S for predicting POPF were determined using the receiver operating characteristic (ROC) curve analysis. Risk factors for POPF of International Study Group on Pancreatic Fistula grade B or higher were examined using univariate and multivariate analyses. Results: POPF occurred in 6 patients (7.6%). ROC curve analyses revealed that the most optimal predictive values of P/S and P-S were 0.74 and -28.8, respectively. Univariate analysis demonstrated that high visceral fat area (p = 0.037), low P/S (p = 0.013), and low P-S (p = 0.006) were significant risk factors of POPF. Multivariate analysis demonstrated that low P/S (OR 10.2 [p = 0.046]) and low P-S (OR 13.2 [p = 0.023]) were significant risk factors of POPF. Conclusion: Fatty pancreas is a risk factor of POPF after radical gastrectomy.

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“…Patients with severe AP are noted to have increased visceral fat, higher serum cytokines (example: Interleukin 6, Monocyte chemoattractant protein -1) and adipokines( eg -resistin and visfatin) [20] NAFLD is an objective marker of visceral obesity. The role of fatty pancreas in patients with NAFLD is not clear [21]. Metabolic fat (central, visceral obesity), as measured by waist circumference or visceral adipose tissue assessment on CT abdomen, predicts a poor outcome in patients with AP better as compared to Body Mass Index (BMI) [13][14][15].…”

Section: Discussionmentioning

confidence: 99%

NAFLD Diagnosed with Abdominal Ultrasound is a Marker of Severity in Acute Pancreatitis

Jasdanwala¹

2015

J Gastrointest Dig Syst

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Objective: Obesity, particularly metabolic obesity, is associated with an increased incidence and enhanced severity of acute pancreatitis (AP). Non Alcoholic Fatty Liver Disease (NAFLD) is a marker of metabolic obesity, which can be easily diagnosed, with the help of initial abdominal ultrasound (AUS) routinely performed in all patients with AP upon admission to assess a biliary etiology. The aim of this study is to identify the clinical utility of detecting NAFLD by AUS in determining the severity of patients with AP Methods: Five hundred and seventy four patients with non-alcoholic AP were divided into two groups on the basis of presence or absence of NAFLD detected by AUS at the time of admission. The diagnosis of NAFLD was based solely on imaging findings. Well-established single markers of prognosis as well as scoring systems were studied in both groups. The data was analyzed using the student's t-test, chi-square test and multivariate regression analysis. Results:Patients with NAFLD had a more severe disease as compared to patients without NAFLD as measured by single markers of prognosis like serum albumin, mean length of stay, ICU admission and mortality as well as scoring systems like BISAP score and Modified Atlanta Classification system ( P value < 0.05) BMI, by itself, was not associated with any difference in outcomes in patients with and without NAFLD as assessed by multivariate regression analysis. Age, sex and individual components of metabolic syndrome also had no influence on the prognostic markers Conclusion: Presence of NAFLD as diagnosed by early AUS can be used as an additional single marker of prognosis in AP. The diagnosis of NAFLD is objective and almost always available at the time of initial presentation of AP.

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A prospective evaluation of fatty pancreas by using EUS

Cited by 134 publications

References 20 publications

Fatty Pancreas, Insulin Resistance, and β-Cell Function: A Population Study Using Fat-Water Magnetic Resonance Imaging

Fatty Pancreas, Insulin Resistance, and β-Cell Function: A Population Study Using Fat-Water Magnetic Resonance Imaging

Risk Factor of Pancreatic Fistula after Radical Gastrectomy from the Viewpoint of Fatty Pancreas

NAFLD Diagnosed with Abdominal Ultrasound is a Marker of Severity in Acute Pancreatitis

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