Associations between Intra-Pancreatic Fat Deposition, Pancreas Size, and Pancreatic Enzymes in Health and after an Attack of Acute Pancreatitis

Abstract

<b><i>Introduction:</i></b> Ectopic fat deposition in the pancreas is involved in the pathogenesis of metabolic sequelae following an attack of pancreatitis. However, its relationship with the exocrine pancreas has never been explored in this setting. The aim was to investigate the associations between intra-pancreatic fat deposition (IPFD), pancreas size, and pancreatic enzymes. <b><i>Methods:</i></b> This cross-sectional study recruited individuals with a history of acute pancreatitis and healthy controls. All participants underwent 3T magnetic resonance imaging, from which IPFD, total pancreas volume (TPV), and pancreas diameters (across the head, body, and tail) were measured independently by 2 raters in a blinded fashion. Circulating levels of pancreatic amylase, pancreatic lipase, and chymotrypsin were measured in a fasted state. A series of linear regression analyses was conducted, accounting for possible confounders. <b><i>Results:</i></b> A total of 108 individuals with pancreatitis and 60 healthy controls were studied. There was a statistically significant difference in IPFD (<i>p</i> < 0.001), but not in TPV (<i>p</i> = 0.389), between the groups. In the post-pancreatitis group, IPFD was significantly inversely associated with pancreas tail diameter (β = −0.736, <i>p</i> = 0.036 in the most adjusted model). In the control group, IPFD was significantly inversely associated with TPV (β = −3.557, <i>p</i> = 0.026 in the most adjusted model). Levels of pancreatic amylase were significantly directly associated with pancreas tail diameter in the post-pancreatitis group (β = 3.891, <i>p</i> = 0.042 in the most adjusted model), whereas levels of pancreatic lipase were significantly inversely associated with TPV in the control group (β = −10.533, <i>p</i> = 0.024 in the most adjusted model). <b><i>Conclusion:</i></b> Increased IPFD in individuals after an attack of pancreatitis is associated with reduced pancreas tail diameter, which is in turn associated with reduced circulating levels of pancreatic amylase. The relationship between IPFD and the exocrine pancreas warrants further investigations.

Relationship of Serum Bile Acids with Fat Deposition in the Pancreas, Liver, and Skeletal Muscle

“…47,48 Nevertheless, a complete clinical resolution was observed in all study participants at the time of magnetic resonance image acquisition. [20][21][22][23] The protocol to measure IHFD in the present study might have been suboptimal as we did not use T1 and T2 correction of water signal and lipid signal from single echo magnetic resonance spectroscopy data. Future studies may need to do this with individually measured relaxation times (especially, if individuals with pancreatic fibrosis or iron overload are included).…”

“…The present cross-sectional study was part of the ARIES project. [20][21][22][23] Adults with a history of acute pancreatitis who gave informed consent to undergo follow-up with a view to identifying metabolic derangements after hospitalisation were eligible for the project. The exclusion criteria were detailed elsewhere.…”

Relationship between Habitual Intake of Vitamins and New-Onset Prediabetes/Diabetes after Acute Pancreatitis

“…Fat-soluble vitamin deficiencies are rare; however, insufficiency may occur in sub-populations including individuals with very low fat intake, low energy intake, or vegetarian/vegan diets [ 38 ]. Due to the dependence on dietary fat intake for absorption of fat-soluble vitamins, individuals with malabsorptive conditions, such as exocrine pancreatic dysfunction (EPD), may also develop subsequent deficiencies in these vitamins [ 19 , 39 , 40 ].…”

A novel second-stage surgical strategy for severely obese patient with pancreatic neuroendocrine tumor: a case report

“…Therefore, we consider that LSG as a first-stage surgery could reduce the risk of T2D onset after LSPDP. Currently, clinical importance of the qualitative evaluation of the pancreatic ectopic accumulation seems to be higher, because there have been some reports relationships between pancreatic ectopic fat accumulation and T2D, acute pancreatitis, and post-endoscopic retrograde cholangiopancreatography pancreatitis [ 7 , 16 , 17 ]. We previously employed measuring PV and CT values, since there are some useful modalities such as iterative decomposition of water and fat with echo asymmetry and least squares estimation magnetic resonance imaging to evaluate the pancreatic ectopic accumulation [ 14 , 18 ].…”