Pancreas

Clin Gastroenterol Hepatol. 2022;20(9):2014–22.e4

Chan TT, Tse YK, Lui RNS, Wong GLH, Chim AML, Kong APS, Woo J, Yeung DKW, Abrigo JM, Chu WCW, Wong VWS, Tang RSY

Fatty pancreas is independently associated with subsequent diabetes mellitus development: A 10-year prospective cohort study

Background and aims: Although the association between fatty pancreas and metabolic syndrome has been suggested in retrospective studies, long-term prospective data on the effect of fatty pancreas on various metabolic outcomes are lacking. The authors aimed to prospectively investigate the association between fatty pancreas and the development of major metabolic outcomes.
Methods: A total of 631 subjects from a population study using fat-water magnetic resonance imaging to quantify pancreatic and liver fat content during 2008 and 2010 were followed up prospectively until December 2020 (mean follow-up time, 11.1 ± 1.1 years). Subjects with significant alcohol intake and diabetes mellitus (DM) at baseline were excluded. Incidence of newly diagnosed DM, hypertension, dyslipidemia, ischemic heart disease, cardiovascular accidents, pancreatic cancer, and mortality were evaluated.
Results: Among the 631 subjects (mean age, 48 ± 11 years), 93 (14.7%) had fatty pancreas. The fatty pancreas group had a higher incidence of DM (33.3% vs. 10.4%; p < 0.001), hypertension (37.7% vs. 22.7%; p = 0.003), and dyslipidemia (37.7% vs. 14.6%; p < 0.001) during long-term follow-up evaluation. Individuals with both fatty liver and pancreas had the highest DM incidence, followed by fatty liver only and fatty pancreas only groups (p < 0.001). Fatty pancreas was associated independently with DM (adjusted hazard ratio [aHR] = 1.81, 95% confidence interval [CI]: 1.10–3.00; p = 0.020), but not hypertension or dyslipidemia on multivariate analysis. Each percentage increase of pancreatic fat increased the risk of incident DM by 7% (aHR = 1.07, 95% CI: 1.01–1.13; p = 0.016). No participants developed pancreatic cancer during the follow-up period.

Conclusions: Fatty pancreas is associated independently with subsequent diabetes mellitus development, but not hypertension or dyslipidemia.

Prof. Dr. V.W.S. Wong or Prof. Dr. R.S.Y. Tang, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong,
E-Mail: wongv@cuhk.edu.hk

or

E-Mail: raymondtang@cuhk.edu.hk

DOI: 10.1016/j.cgh.2021.09.027

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