Impact of fatty pancreas and lifestyle on the development of subclinical chronic pancreatitis in healthy people undergoing a medical checkup

Abstract

BackgroundAlthough fat accumulation in human organs is associated with a variety of diseases, there is little evidence about the effect of a fatty pancreas on the development of subclinical chronic pancreatitis over the clinical course.MethodsWe conducted a prospective cohort study from 2008 to 2014 of patients who underwent a medical checkup consultation for fat accumulated in the pancreas. Patients included in the analysis were divided into a non-fatty pancreas group (n = 9710) and fatty pancreas group (n = 223). The primary end point was the odds ratio (OR) for chronic pancreatitis associated with fatty pancreas, which was diagnosed using ultrasonography. We used a multiple logistic regression model to estimate the OR and the corresponding 95% confidence interval (CI).ResultsNinety-two people were diagnosed with chronic pancreatitis, including both presumptive and definitive diagnoses. Twelve people were diagnosed with chronic pancreatitis by ultrasonography among the 223 patients with fatty pancreas, and 80 patients among 9710 were diagnosed with non-fatty pancreas. The crude OR was 6.85 (95% CI 3.68, 12.75), and the multiple adjusted OR was 3.96 (95% CI 2.04, 7.66).ConclusionsFat accumulation in the pancreas could be a risk factor for developing subclinical chronic pancreatitis.

Post-pancreatitis diabetes mellitus and excess intra-pancreatic fat deposition as harbingers of pancreatic cancer

“…An earlier study from the United States found that individuals with chronic pancreatitis alone ( n = 35) had a significantly greater IPFD in comparison with controls ( n = 50) in a post-hoc analysis constrained to non-obese people only (body mass index < 30 kg/m 2 )[ 33 ]. A longitudinal study from Japan sought to investigate the temporal relationship between IPFD and chronic pancreatitis[ 34 ]. A total of 9933 individuals without pancreatitis were examined in 2008 and followed up for 4 years as part of their medical check-up.…”

“…A total of 9933 individuals without pancreatitis were examined in 2008 and followed up for 4 years as part of their medical check-up. The presence of fatty pancreas disease at baseline was associated with a 3.9-times higher risk of incident pancreatitis during follow-up (odds ratio 3.9; 95% confidence interval 2.0 to 7.7), after adjustment for age, sex, body mass index, glycated hemoglobin, systolic blood pressure, alcohol abuse, tobacco smoking, and other covariates[ 34 ]. However, it is worth noting that transabdominal ultrasound was used in this study, which is suboptimal for diagnosing of both chronic pancreatitis and fatty pancreas disease.…”

Does Nonalcoholic Pancreatic Steatosis Always Correlate with Nonalcoholic Fatty Liver Disease?

“…18,19 The role of NAPS is still debatable in acute and chronic pancreatitis, pancreatic cancer, and pancreatic exocrine insufficiency. 20 Older age, high BMI, and insulin resistance are reportedly associated with NAPS, 9,12,21,22 although some studies have found no relation between NAPS and beta-cell function. 23 Fat infiltration of the pancreas may lead to more bleeding and post-operative fistula formation in pancreatic surgery.…”

Nonalcoholic fatty pancreas disease: An emerging clinical challenge

“…At the same time, this is also a challenge in obese patients to exhibit an apparent pancreas[ 44 ]. Pancreatic fat accumulation appears hyperechoic as compared with liver or kidney accumulation, a reference point for diagnosis[ 45 , 46 ]. Some studies have established that echogenicity of retroperitoneal fat suggests a higher amount of pancreatic fat deposition, using a grading system[ 22 , 25 , 7 ].…”