Ectopic fat deposition and its related abnormalities of lipid metabolism followed by nonalcoholic fatty pancreas

Abstract

Background and Objectives: The positive energy balance between caloric intake and caloric output increasing storage of triglycerides (TG) in adipocytes has made nonalcoholic fatty liver disease (NAFLD) one of the major public health problems in China. Excessive lipid deposition in the pancreas is referred to as nonalcoholic fatty pancreas disease (NAFPD). Early assessment of pancreatic fat infiltration will have an increasing role in the clinical management of the metabolic dysregulation and prevention pancreatic complications. Subjects and Methods: We retrospectively collected data of inpatients with NAFPD from EUS database between September 2012 and August 2020 at our endoscopic center. The prevalence of NAFPD and factors associated with its development were statistically analyzed. The echogenicity of the pancreas was compared to that of the left renal cortex during the EUS examination by using an existing criterion. Results: Four thousand, seven hundred and four consecutive individuals underwent EUS were enrolled. The prevalence of NAFPD was 1.2% (57/4704). Factors independently associated with NAFPD on multivariate analysis were increasing TG (odds ratios [OR] 4.65, P = 0.014), NAFLD (OR 16.76, P = 0.005) and decreasing apolipoprotein A-1 (OR 0.002, P = 0.0127). We found no association between NAFPD and age, sex, total cholesterol or hypertension. Conclusions: We found a meaningful relationship between NAFLD, dyslipidemia, and NAFPD in Chinese. We hypothesized that NAFPD was strongly correlated with ectopic fat deposition and its related abnormalities of lipid metabolism. Early diagnosis of NAFLD provides opportunities to control the progression of NAFPD.

Bidirectional association between non-alcoholic fatty liver disease and fatty pancreas: a systematic review and meta-analysis

“…However, the heterogeneity was explored in subgroup analyses, and the results showed consistency in all subgroups. Third, although 14 of 26 included studies adjusted for at least one potential confounder, only 11 studies adjusted for cardiometabolic risk factors, especially insulin resistance, diabetes mellitus, and obesity [10][11][12]16,17,21,23,24,29,31,32]. It is conceivable that the association between fatty pancreas and NAFLD may be a result of confounders.…”

“…Of the 26 articles, 24 were full-text articles, and two were conference abstracts. Nineteen studies, involving a total of 52 723 subjects, reported the odds of fatty pancreas in patients with and without NAFLD [11,12,[14][15][16][17]19,[21][22][23][24]26,[29][30][31][32][33]41,42]. Three articles, with a total of 802 patients, evaluated the odds of NAFLD in patients with and without fatty pancreas [13,28,34].…”

“…Subsequently, 85 articles underwent the second round of review. Finally, 26 observational studies comprising a total of 67 803 patients were included in the analysis: 4 case-control studies and 22 cross-sectional studies [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]26,[28][29][30][31][32][33][34]41,42]. No longitudinal cohort studies reporting the outcomes of interest were identified.…”

“…The meta-analysis of the 19 included studies [11,12,[14][15][16][17]19,[21][22][23][24]26,[29][30][31][32][33]41,42] is presented in Fig. 2.…”

“…Age, sex, ethnicity, unhealthy lifestyle, and metabolic disorders have been recognized as the common risk factors for fatty pancreas [3,7,9]. Growing evidence has shown associations between fat content in the pancreas and the liver, suggesting a potential relationship between fatty pancreas and NAFLD [10–34]. Some research has discovered evidence that fatty pancreas contributes to fat accumulation in the liver, potentially accelerating the progression of NAFLD [18].…”