The effect of fatty pancreas on serum glucose parameters in patients with nonalcoholic steatohepatitis

Uygun, Ahmet; Kadayıfçı, Abdurrahman; Demirci, Hakan; Sağlam, Mutlu; Sakin, Yusuf Serdar; Öztürk, Kayhan; Polat, Zülfıkar; Karslioğlu, Yıldırım; Bolu, Erol

doi:10.1016/j.ejim.2014.11.007

Cited by 71 publications

(75 citation statements)

References 25 publications

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“…Although the prevalence for NAFPD in general paediatric population is not available, it has been reported a prevalence of 16% in the general adults with an increase of this percentage in obese subjects with fatty liver. 10 Recently, in fact, Uygun et al 26 reported a prevalence of fatty pancreas at ultrasound examination in about 50% of adults with biopsy-proven NASH. The results of our study reported a prevalence of fatty pancreas in approximately half of children with NAFLD, and this percentage was of about 80% in patients with biopsy-proven NASH.…”

Section: Discussionmentioning

confidence: 99%

Nonalcoholic fatty pancreas disease and Nonalcoholic fatty liver disease: more than ectopic fat

Corte

Mosca

Majo

et al. 2015

Clinical Endocrinology

101

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SummaryObjective The aim of this study was to evaluate the metabolic effects of fatty pancreas (nonalcoholic fatty pancreas disease -NAFPD) in a group of obese paediatric patients with nonalcoholic fatty liver disease (NAFLD). Methods We included 121 consecutive children with echographic evidence of hepatic steatosis. All patients underwent to abdominal ultrasound to evaluate pancreatic echogenic pattern. We divided the patients into two groups on the basis of the presence of fatty pancreas. In all patients liver function tests, lipid and gluco-insulinemic profile were evaluated. A selected subset of patients (67) underwent to liver biopsy. Results Of these 121 patients, 58 showed NAFPD and 63 patients exhibited a normal pancreatic echogenic pattern. No differences were found in age, transaminases serum levels, lipid profile and pancreatic enzymes between the two groups. The patients with NAFPD had a significantly higher z-BMI, fasting insulin, insulin resistance (HOMA-IR) and lower ISI respect to the group without fatty pancreas. The patients with fatty pancreas showed a more advanced form of liver disease, with higher values of fibrosis, ballooning and NAS score with respect to the group without NAFPD. Conclusions Our study demonstrated that NAFPD is a frequent condition in obese paediatric patients affected by NAFLD. Our data suggest that pancreatic fat should not be considered an inert accumulation of fat, but as an additional factor able to affect glucose metabolism and severity of liver disease, increasing the risk of develop metabolic syndrome.

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Section: Discussionmentioning

confidence: 99%

Nonalcoholic fatty pancreas disease and Nonalcoholic fatty liver disease: more than ectopic fat

Corte

Mosca

Majo

et al. 2015

Clinical Endocrinology

101

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“…By EUS, the echogenicity of the pancreas can also be compared with the one of retroperitoneal fat[65]. In addition, EUS may also be associated with FNAC for cytological analysis[36].…”

Section: How To Assess Pancreatic Fatmentioning

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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“…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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The effect of fatty pancreas on serum glucose parameters in patients with nonalcoholic steatohepatitis

Cited by 71 publications

References 25 publications

Nonalcoholic fatty pancreas disease and Nonalcoholic fatty liver disease: more than ectopic fat

Nonalcoholic fatty pancreas disease and Nonalcoholic fatty liver disease: more than ectopic fat

Exploring the metabolic syndrome: Nonalcoholic fatty pancreas disease

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

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