Fatty Pancreas: Linking Pancreas Pathophysiology to Nonalcoholic Fatty Liver Disease

Abstract

Currently, scientific interest has focused on fat accumulation outside of subcutaneous adipose tissue. As various imaging modalities are available to quantify fat accumulation in particular organs, fatty pancreas has become an important area of research over the last decade. The pancreas has an essential role in regulating glucose metabolism and insulin secretion by responding to changes in nutrients under various metabolic circumstances. Mounting evidence has revealed that fatty pancreas is linked to impaired β-cell function and affects insulin secretion with metabolic consequences of impaired glucose metabolism, type 2 diabetes, and metabolic syndrome. It has been shown that there is a connection between fatty pancreas and the presence and severity of nonalcoholic fatty liver disease (NAFLD), which has become the predominant cause of chronic liver disease worldwide. Therefore, it is necessary to better understand the pathogenic mechanisms of fat accumulation in the pancreas and its relationship with NAFLD. This review summarizes the epidemiology, diagnosis, risk factors, and metabolic consequences of fatty pancreas and discusses its pathophysiology links to NAFLD.

Automated image analysis method to detect and quantify fat cell infiltration in hematoxylin and eosin stained human pancreas histology images

“…Pancreatic fat accumulation has been associated with obesity, impaired b-cell function and may be an early sign in the development of metabolic syndrome (Dite et al 2020, Sequeira et al 2022, Rugivarodom et al 2022). Pancreas is a heterogenous tissue and current tools for fat cell analysis such as Adiposoft (Galarraga et al 2012), AdipoCount (Zhi et al 2018) are unable to analyze fat cell infiltration in pancreas.…”

Medical imaging in the assessment of cardiovascular disease risk

“…However, increasing literature showed that individuals suffering from chronic pancreatitis have fatter pancreas compared with healthy individuals [40]. Pancreatic steatosis can have adverse effects on metabolism and may play an important role in the development of CVD and metabolic disorders [41], and certain cancers [42]. Concerning the metabolic disturbances, pancreatic adipose tissue has been associated with an increased risk of developing T2DM, and several studies observed higher pancreas adipose tissue accumulation in patients with T2DM compared with normoglycemic individuals, although no associations have been also observed [40].…”

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

“…Cardiometabolic disorders, particularly obesity and type 2 diabetes mellitus become a global pandemic, affecting 20-30% of the adult population as a consequence of physical inactivity and excessive consumption of the Western diet [1]. These metabolic disorders increased the amount of free fatty acids in the blood, which then accumulated in visceral adipose tissues and other organs including the liver [2,3]. Intrahepatic fat accumulation causes non-alcoholic fatty liver disease (NAFLD), one of the most prevalent chronic liver diseases with a 30% global prevalence [3].…”

“…These metabolic disorders increased the amount of free fatty acids in the blood, which then accumulated in visceral adipose tissues and other organs including the liver [2,3]. Intrahepatic fat accumulation causes non-alcoholic fatty liver disease (NAFLD), one of the most prevalent chronic liver diseases with a 30% global prevalence [3]. Through intrahepatic lipotoxicity, NAFLD can progress from simple steatosis to non-alcoholic steatohepatitis (NASH), cirrhosis, hepatic decompensation, and hepatocellular carcinoma [4].…”

“…Insulin resistance facilitates the accumulation of fat in extrahepatic organs such as the pancreas. Excessive lipid storage in pancreatic tissue is described as fatty pancreas, which is also known as non-alcoholic fatty pancreas and pancreatic steatosis [3]. It affects about one-third of individuals with metabolic syndrome [7].…”