Association between novel MRI‐estimated pancreatic fat and liver histology‐determined steatosis and fibrosis in non‐alcoholic fatty liver disease

Abstract

SUMMARY Background Ectopic fat deposition in the pancreas and its association with hepatic steatosis have not previously been examined in patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD). Aim To quantify pancreatic fat using a novel magnetic resonance imaging (MRI) technique and determine whether it is associated with hepatic steatosis and/or fibrosis in patients with NAFLD. Methods This is a cross-sectional study including 43 adult patients with biopsy-proven NAFLD who underwent clinical evaluation, biochemical testing and MRI. The liver biopsy assessment was performed using the NASH-CRN histological scoring system, and liver and pancreas fat quantification was performed using a novel, validated MRI biomarker; the proton density fat fraction. Results The average MRI-determined pancreatic fat in patients with NAFLD was 8.5% and did not vary significantly between head, body, and tail of the pancreas. MRI-determined pancreatic fat content increased significantly with increasing histology-determined hepatic steatosis grade; 4.6% in grade 1; 7.7% in grade 2; 13.0% in grade 3 (P = 0.004) respectively. Pancreatic fat content was lower in patients with histology-determined liver fibrosis than in those without fibrosis (11.2% in stage 0 fibrosis vs. 5.8% in stage 1–2 fibrosis, and 6.9% in stage 3–4 fibrosis, P = 0.013). Pancreatic fat did not correlate with age, body mass index or diabetes status. Conclusions In patients with NAFLD, increased pancreatic fat is associated with hepatic steatosis. However, liver fibrosis is inversely associated with pancreatic fat content. Further studies are needed to determine underlying mechanisms to understand if pancreatic steatosis affects progression of NAFLD.

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

“…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. With the development of magnetic resonance-based techniques, it is now possible to quantify organ fat content with high accuracy and reproducibility ( 31,32 ). Other groups have used MRI to study small cohort of patients ( 12,13,31,33,34 ).…”

Nonalcoholic fatty liver disease with cirrhosis increases familial risk for advanced fibrosis

“…This is a cross-sectional analysis of a prospectively recruited cohort of probands with NAFLD-cirrhosis and their first-degree relatives enrolled between February 2013 and March 2016. All patients were invited for a clinical research visit and underwent a standardized history, anthropometric examination, physical examination, and biochemical testing at the University of California, San Diego (UCSD), NAFLD Research Center (16,17,27,(30)(31)(32)(33). All participants underwent phenotyping based on advanced MRI.…”

“…history, physical examination, and testing to rule out other causes of chronic liver diseases (see inclusion and exclusion criteria for further details) and fasting laboratory tests at the UCSD NAFLD Research Center (16,17,27,(30)(31)(32)(33), and then underwent an advanced magnetic resonance examination including MRI-PDFF and MRE at the UCSD MR3T Research Laboratory for the screening of NAFLD and advanced fibrosis (29,34,35). Research visits and MRI procedures for each twin pair were performed on the same day.…”

“…MRI-PDFF was used to measure hepatic steatosis, and MRE was used to measure hepatic fibrosis. The details of the MRI protocol have been previously described in references (31,40). The image analysts were blinded to all clinical and biochemical data, including the study group of the participants.…”

949 Sitagliptin Versus Placebo in the Treatment of Nonalcoholic Fatty Liver Disease: A Randomized Controlled Trial

“…39,40 PDFF measurements are independent of confounders that frequently confound fat quantification via conventional MRI techniques, including scanner manufacturer, scanner platform, and field strength. 41,42 Previously, we have shown the utility of MRI-PDFF for assessing treatment response in NASH trials.…”