Pancreatic fat content by magnetic resonance imaging in subjects with prediabetes, diabetes, and controls from a general population without cardiovascular disease

Abstract

Background/ObjectiveDespite the relevance of pancreatic fat content in the development of metabolic diseases, its association with impaired glucose metabolism, diabetes, and other adipose tissue compartments remains unclear. Thus, we determined differences in pancreatic fat content by magnetic resonance imaging (MRI) between subjects with prediabetes, diabetes, and normal controls in a cohort from the general population.MethodsSubjects without history of cardiovascular disease with established diabetes or prediabetes as well as normal controls were included and underwent whole-body MRI on a 3T scanner. Pancreatic fat content was quantified by measuring the proton-density fat fraction (PDFFpanc) using a 3D multi-echo GRE sequence (increment: 1.23 ms, 6 echoes) by placing ROIs in the pancreatic head, body, and tail by independent readers. In addition, hepatic fat content as well as abdominal subcutaneous and visceral adipose tissue (SAT and VAT) were measured by multi-echo GRE and 3D 2-point volume-interpolated DIXON MRI, respectively. Univariate and multivariate analyses were employed to determine associations.ResultsA total of 385 subjects were included in the analysis (median age: 57 years, 58.2% males), of them 53 were classified as subjects with diabetes, 95 as prediabetes, and 237 as controls (13.8%, 24.7%, and 61.6%; respectively). The median PDFFpanc was 5.2% [IQR 3.3–9.4], and significantly higher in subjects with prediabetes and diabetes as compared to controls (PDFFpanc: 6.2% [IQR: 3.5–12] vs. 8.6% [IQR: 4.3–17.5] vs. 4.9% [3.1–7.4], p<0.001, respectively). After adjusting for age, gender and BMI the association was attenuated (all p>0.12). While in univariate analysis BMI, PDFFhepatic, SAT and VAT were associated with PDFFpanc (all p<0.05), only VAT predicted PDFFpanc independently (β: 0.02, 95%-confidence interval: 0.01–0.04, p<0.001).ConclusionWhile pancreatic fat content differs significantly between subjects with prediabetes, diabetes and controls, this association may be confounded by age, gender, and the amount of VAT in this cross-sectional study.

Renal and Renal Sinus Fat Volumes as Quantified by Magnetic Resonance Imaging in Subjects with Prediabetes, Diabetes, and Normal Glucose Tolerance

“…These findings show, that both VAT and renal sinus fat may show interactions as perivascular adipose tissue, similarly to pericardial and hepatic fat. These findings are similar to another study investigating the same study cohort, showing that pancreatic fat content differs significantly between subjects with prediabetes, diabetes and controls, but that association is confounded by age, gender, and the amount of VAT (15).…”

Obesity, metabolic disease and the pancreas—Quantitative imaging of pancreatic fat

“…Pancreatic PDFF validation data with MRS has been modest, explained in part by some of the limitations of pancreatic MRS, 44 and the non-uniform distribution of fat through the pancreas as measured with PDFF. 70 The association of pancreatic PDFF with diabetes is controversial, with large sample studies reporting increased 71,72 and unchanged 70,73 levels of pancreatic fat. Association with insulin resistance has also been reported, 74 as have modest associations with visceral and subcutaneous adiposity.…”

Pilot study on longitudinal change in pancreatic proton density fat fraction during a weight‐loss surgery program in adults with obesity

“…2 A marker of insulin resistance and metabolic dysregulation, excess fat is pathogenic and contributes to organ dysfunction, incites systemic inflammation, and increases the risk of type 2 diabetes (DM-2) and cardiovascular disease. [6][7][8][9] In the pancreas, excess fat accumulation has been associated with beta cell dysfunction, insulin resistance, DM-2, pancreatitis, and pancreatic cancer. 2,[10][11][12] Weight loss is known to reduce liver fat, 13,14 which can be measured with proton density fat fraction (PDFF), a noninvasive quantitative biomarker designed to measure liver fat using confounder-corrected chemical-shift-encoded magnetic resonance imaging (CSE-MRI).…”