Prevalence of Non-Alcoholic Fatty Pancreas Disease (NAFPD) and its risk factors among adult medical check-up patients in a private hospital: a large cross sectional study

Abstract

BackgroundThe clinical significance of non-alcoholic fatty pancreatic disease (NAFPD) or fatty pancreas is largely unknown. It is often an incidental finding on abdominal ultrasound, which is not explored further, especially its association with metabolic condition and the risk of pancreatic malignancy. The aim of this study is to evaluate the presence of NAFPD and its associated risk factors among adult medical check-up patients.MethodA large cross-sectional study was done among adult medical check-up patients underwent abdominal ultrasound between January and December 2013 in Medistra Hospital, Jakarta. Data was obtained from the patients’ medical record and include demographic data, blood pressures, fasting blood glucose level, and lipid profile. The presence of fatty pancreas was diagnosed by ultrasound. Bivariate and multivariate analyses were done to find associated risk factors for NAFPD. Statistical analysis was done using SPSS version 17.ResultsA total of 1054 cases were included in this study; pancreas cannot be visualized in 153 cases and were excluded from the analysis. Fatty pancreas was present in 315 (35.0 %) patients. Bivariate analyses found associations among fatty pancreas and several risk factors such as gender, age, systolic and diastolic blood pressures, body mass index (BMI), fasting plasma glucose (FPG), triglycerides (TG) and cholesterol levels.ConclusionFatty pancreas is a common finding during medical check-up with a prevalence of 35 %. Fatty pancreas has significant association with metabolic factors and it might have an important role in risk of malignancy.

Hypertension, but not body mass index, is predictive of increased pancreatic lipid content and islet dysfunction

“…These sex‐specific differences may be one reason that various population‐level studies including both men and women have found only modest trends relating Panc‐LC with other variables. Taken together, our data suggest that BMI and age play a sex‐specific role in pancreatic steatosis, which has been reported in only a few prior imaging studies . Additionally, we found a significant correlation between Panc‐LC and Islet‐LC, which has not previously been reported.…”

“…To complicate this, some studies also incorrectly include accumulated visceral fat around the exterior of the organ in their measurements, either due to technical difficulty to distinguish or by ambiguous definition of steatosis. MRI, MRS, ultrasonography, and CT studies of live patients have correlated different clinical parameters with increased pancreas fat infiltration, including diabetes, BMI/obesity, heavy alcohol use, metabolic syndrome, increased age, hypertension (HTN), visceral adipose tissue, race/ethnicity, waist circumference, male sex, dyslipidemia, and hyperglycemia . In particular, BMI has had mixed results regarding its relationship with pancreas fat quantified by imaging.…”

“…To this end, several studies have attempted to characterize pancreatic steatosis in humans using histopathology 10,11 and in vivo imaging techniques, including magnetic resonance imaging (MRI), [12][13][14][15][16][17][18][19][20] magnetic resonance spectroscopy (MRS), [21][22][23][24] ultrasonography, [25][26][27][28][29][30][31][32][33] computed tomography (CT), [34][35][36] and combinations of these techniques. 37,38 Although MRI and MRS remain the most sensitive imaging options for estimating donor pancreas fat content in vivo, these techniques are time-consuming and impractical to incorporate into the donor workflow.…”

“…To complicate this, some studies also incorrectly include accumulated visceral fat around the exterior of the organ in their measurements, either due to technical difficulty to distinguish or by ambiguous definition of steatosis. MRI, MRS, ultrasonography, and CT studies of live patients have correlated different clinical parameters with increased pancreas fat infiltration, including diabetes, 16,21,23,24,30,32,36 BMI/obesity, 12,14,16,18,21,24,25,27,29,[31][32][33][34][35] heavy alcohol use, 25 metabolic syndrome, 28,31,33 increased age, 14,15,24,26,29,32,35,37 hypertension (HTN), 26,29,33 visceral adipose tissue, 12,14,18,26,28 race/ethnicity, 14,22 waist circumference, 12,18 male sex, 18,26,29 dyslipidemia, 14,…”

Use of Coxsackievirus B3 as a Model of Acute Pancreatitis

“…Recently, NAFPD has been characterized and associated with diminished pancreatic function and elevated risk of diabetes mellitus (22,43). A large cross-sectional study found that fatty pancreas was present in 35% of patients presenting for a medical check-up, demonstrating its prevalence (18).…”