The association between ectopic fat in the pancreas and subclinical atherosclerosis in type 2 diabetes

Kim, Mee Kyoung; Chun, Honggu; Park, Jin Hee; Yeo, Dong Myung; Baek, Kwang‐Hyun; Song, Ki‐Ho; Chung, Dong Jin; Kwon, Hyuk‐Sang

doi:10.1016/j.diabres.2014.09.005

Cited by 50 publications

(43 citation statements)

References 24 publications

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“…In line with this, a study designed to compare pancreatic fat content and beta cell function found increased lipid deposition in the pancreas of diabetic patients as compared to healthy subjects [24]. Furthermore, in T2DM patients, obesity was associated with lower pancreatic density evaluated by CT, indicating higher pancreatic fat content [30]. In reverse order, return of normal insulin secretion and reduction of pancreatic fat content has been demonstrated after eight weeks of a low energy intake diet [40].…”

Section: Discussionmentioning

confidence: 92%

Pancreatic size and fat content in diabetes: A systematic review and meta-analysis of imaging studies

2017

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ObjectivesImaging studies are expected to produce reliable information regarding the size and fat content of the pancreas. However, the available studies have produced inconclusive results. The aim of this study was to perform a systematic review and meta-analysis of imaging studies assessing pancreas size and fat content in patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM).MethodsMedline and Embase databases were performed. Studies evaluating pancreatic size (diameter, area or volume) and/or fat content by ultrasound, computed tomography, or magnetic resonance imaging in patients with T1DM and/or T2DM as compared to healthy controls were selected. Seventeen studies including 3,403 subjects (284 T1DM patients, 1,139 T2DM patients, and 1,980 control subjects) were selected for meta-analyses. Pancreas diameter, area, volume, density, and fat percentage were evaluated.ResultsPancreatic volume was reduced in T1DM and T2DM vs. controls (T1DM vs. controls: -38.72 cm3, 95%CI: -52.25 to -25.19, I2 = 70.2%, p for heterogeneity = 0.018; and T2DM vs. controls: -12.18 cm3, 95%CI: -19.1 to -5.25, I2 = 79.3%, p for heterogeneity = 0.001). Fat content was higher in T2DM vs. controls (+2.73%, 95%CI 0.55 to 4.91, I2 = 82.0%, p for heterogeneity<0.001).ConclusionsIndividuals with T1DM and T2DM have reduced pancreas size in comparison with control subjects. Patients with T2DM have increased pancreatic fat content.

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Section: Discussionmentioning

confidence: 92%

Pancreatic size and fat content in diabetes: A systematic review and meta-analysis of imaging studies

2017

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“…Data from 1 study (Kim et al) were reported in 2 subgroups (and counted as 2 cohorts in the present meta‐analysis).…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies, 10,14,16,19,[21][22][23][24] which included a total of 11 225 individuals, reported on the prevalence of FP. From these studies, 14 markers were available for meta-analysis (…”

Section: Biological Markers and Fpmentioning

confidence: 99%

Ectopic fat accumulation in the pancreas and its biomarkers: A systematic review and meta‐analysis

Singh

Yoon

Poppitt

et al. 2017

Diabetes Metabolism Res

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Presence of fat in the pancreas increases the risk of metabolic co-morbidities. Detection and quantification of pancreatic fat is not a routine clinical practice, at least in part because of need to use expensive imaging techniques. We aimed to systematically review common markers of pancreatic fat in blood and to investigate differences in these markers associated with fatty pancreas. The search was conducted in 3 databases (EMBASE, Scopus, and MEDLINE). Studies in humans were eligible for inclusion if they reported on biological markers and percentage of pancreatic fat or fatty pancreas prevalence. Data were pooled for correlation and effect size meta-analysis. A total of 17 studies including 11 967 individuals were eligible for meta-analysis. Markers of lipid metabolism, including circulating triglycerides (r = 0.38 [95% confidence interval (CI) 0.31, 0.46]) and high-density lipoprotein cholesterol (r = -0.33 [95% CI -0.35, -0.31]), and markers of glucose metabolism, including glycated haemoglobin (r = 0.39 [95% CI 0.30, 0.48], insulin (r = 0.38 [95% CI 0.33, 0.43]), and homeostasis model assessment-insulin resistance (r = 0.37 [95% CI 0.30, 0.44], yielded the best correlations with percentage of pancreatic fat. Further, effect size analysis showed large and medium effects for the above markers of lipid and glucose metabolism. Circulating levels of triglycerides and glycated haemoglobin appear to be the best currently available markers of pancreatic fat. The approach of non-invasive and accurate detection of pancreatic fat by blood analysis should be further explored in the future, by investigating other potential biological markers of pancreatic fat.

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“…Recently, one study[167] found that pancreatic steatosis may be an independent risk factor on the development of carotid atherosclerosis in non-obese subjects with T2DM. Therefore, it could be a marker of a higher risk of cardiovascular disease, especially in non-obese subjects.…”

Section: Clinical Significancementioning

confidence: 99%

Exploring the metabolic syndrome: Nonalcoholic fatty pancreas disease

Catanzaro¹,

Cuffari²,

Italia³

et al. 2016

WJG

162

132

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After the first description of fatty pancreas in 1933, the effects of pancreatic steatosis have been poorly investigated, compared with that of the liver. However, the interest of research is increasing. Fat accumulation, associated with obesity and the metabolic syndrome (MetS), has been defined as “fatty infiltration” or “nonalcoholic fatty pancreas disease” (NAFPD). The term “fatty replacement” describes a distinct phenomenon characterized by death of acinar cells and replacement by adipose tissue. Risk factors for developing NAFPD include obesity, increasing age, male sex, hypertension, dyslipidemia, alcohol and hyperferritinemia. Increasing evidence support the role of pancreatic fat in the development of type 2 diabetes mellitus, MetS, atherosclerosis, severe acute pancreatitis and even pancreatic cancer. Evidence exists that fatty pancreas could be used as the initial indicator of “ectopic fat deposition”, which is a key element of nonalcoholic fatty liver disease and/or MetS. Moreover, in patients with fatty pancreas, pancreaticoduodenectomy is associated with an increased risk of intraoperative blood loss and post-operative pancreatic fistula.

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The association between ectopic fat in the pancreas and subclinical atherosclerosis in type 2 diabetes

Cited by 50 publications

References 24 publications

Pancreatic size and fat content in diabetes: A systematic review and meta-analysis of imaging studies

Pancreatic size and fat content in diabetes: A systematic review and meta-analysis of imaging studies

Ectopic fat accumulation in the pancreas and its biomarkers: A systematic review and meta‐analysis

Exploring the metabolic syndrome: Nonalcoholic fatty pancreas disease

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