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

Wong, Vincent Wai‐Sun; Wong, Grace Lai–Hung; Yeung, David W. K.; Abrigo, Jill; Kong, Alice Pik‐Shan; Chan, Randolph C. H.; Chim, Angel Mei‐Ling; Shen, Jiayun; Ho, Chung-Shun; Woo, Jean; Chu, Winnie Chiu-Wing; Chan, Henry Lik‐Yuen

doi:10.1038/ajg.2014.1

Cited by 214 publications

(217 citation statements)

References 44 publications

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“…In addition, the fat percentage increased from the head to the tail of the pancreas as shown in Figure 3. Finally, in another study, the pancreatic fat increased with BMI only in non-diabetic patients [14] , confirming the previously published data of [12,[15][16][17] .…”

Section: Imaging Aspects Of Exocrine Pancreatic Steatosis: the Era Ofsupporting

confidence: 80%

Pancreatic steatosis: Is it related to either obesity or diabetes mellitus?

Pezzilli¹

2014

WJD

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The accumulation of fat in the pancreatic gland has been referred to using various synonyms, such as pancreatic lipomatosis, fatty replacement, fatty infiltration, fatty pancreas, lipomatous pseudohypertrophy, non-alcoholic fatty pancreatic disease and pancreatic steatosis We believe that pancreatic steatosis is the best description of fat accumulation in the pancreatic gland without fat replacement, and this term also describes the possibility that the fat accumulation is a reversible process. A review of the existing literature was carried out, and it was found that there was notable evidence from both the pathological and the imaging point of view that pancreatic steatosis is an increasing problem due to the increasing incidence of obesity. The conclusion was that pancreatic steatosis was easily detectable using modern imaging techniques, such as ultrasonography, endoscopic ultrasonography, computed tomography and magnetic resonance imaging. Pancreatic steatosis was not due to the presence of diabetes mellitus but was highly associated with the metabolic syndrome. The possible presence of steatopancreatitis should be better evaluated, especially regarding the inflammatory cascade, and additional studies are needed which are capable of assessing whether non-alcoholic steatopancreatitis really exists as does non-alcoholic steatohepatitis. Finally, the presence of exocrine pancreatic function should be extensively evaluated in patients with pancreatic steatosis. Key words: Computed tomography; Endoscopic ultrasonography; Magnetic resonance imaging; Metabolic syndrome; Pancreatic steatosis; Pathology; Type 2 diabetes mellitus; Ultrasonography Core tip: Pancreatic steatosis is easily detectable using modern imaging techniques, such as ultrasonography, endoscopic ultrasonography, computed tomography and magnetic resonance imaging. It is not due to the presence of diabetes mellitus but is highly associated with the metabolic syndrome. The possible presence of steatopancreatitis should be better evaluated, especially regarding the inflammatory cascade, and additional studies are needed which are capable of assessing whether non-alcoholic steatopancreatitis really exists as does non-alcoholic steatohepatitis. Additional studies regarding the exocrine pancreatic function in patients with pancreatic steatosis are needed.

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Section: Imaging Aspects Of Exocrine Pancreatic Steatosis: the Era Ofsupporting

confidence: 80%

Pancreatic steatosis: Is it related to either obesity or diabetes mellitus?

Pezzilli¹

2014

WJD

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“…However, since pancreatic fat content may also be affected by age and obesity, a causal association between pancreatic fat content and glucose intolerance or beta-cell dysfunction is difficult to establish [106,[131][132][133][134][135][136]. In our analysis, using CT scan, there was a significant correlation between pancreatic fat content and BMI, but no significant difference in pancreatic fat volume between subjects with and without T2D who were matched for age, sex, and BMI [13] ( Table 1 and Figure 4).…”

Section: Pancreatic Fat Beta-cell Function and Glucose Intolerancementioning

confidence: 62%

Pancreas Volume and Fat Deposition in Diabetes and Normal Physiology: Consideration of the Interplay Between Endocrine and Exocrine Pancreas

Saisho¹

2016

Rev Diabet Stud

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■ AbstractThe pancreas is comprised of exocrine and endocrine components. Despite the fact that they are derived from a common origin in utero, these two compartments are often studied individually because of the different roles and functions of the exocrine and endocrine pancreas. Recent studies have shown that not only type 1 diabetes (T1D), but also type 2 diabetes (T2D), is characterized by a deficit in beta-cell mass, suggesting that pathological changes in the pancreas are critical events in the natural history of diabetes. In both patients with T1D and those with T2D, pancreas mass and exocrine function have been reported to be reduced. On the other hand, pancreas volume and pancreatic fat increase with obesity. Increased beta-cell mass with increasing obesity has also been observed in humans, and ectopic fat deposits in the pancreas have been reported to cause beta-cell dysfunction. Moreover, neogenesis and transdifferentiation from the exocrine to the endocrine compartment in the postnatal period are regarded as a source of newly formed beta-cells. These findings suggest that there is important interplay between the endocrine and exocrine pancreas throughout life. This review summarizes the current knowledge on physiological and pathological changes in the exocrine and endocrine pancreas (i.e., beta-cell mass), and discusses the potential mechanisms of the interplay between the two compartments in humans to understand the pathophysiology of diabetes better.

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“…FP also showed a strong correlation with metabolic syndrome [7]. IR has been found to be increased in subjects with FP in a recent population study [8].…”

Section: Introductionmentioning

confidence: 94%