Fatty Pancreas Disease and the Risk of Future Diseases of the Exocrine Pancreas: A US Matched Cohort Study.

IF 7.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Arjun Chatterjee, Amandeep Singh, Raj Jessica Thomas, Renan Prado, Ridhima Kaul, Andrew Ford, Rupayan Kundu, Huijun Xiao, Qijun Yang, John McMichael, Dawn Schwartz, Bryan Loebl, Rajat Garg, Charles Martin, Prabhleen Chahal
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引用次数: 0

Abstract

Introduction: Fatty pancreas disease (FPD), marked by excess fat within the pancreas, is often incidentally detected on imaging. Despite recognized metabolic links, its clinical significance remains unclear. More granular data from large, well-characterized US cohorts are needed to clarify its relevance. This study quantified intrapancreatic fat deposition and assess its natural history and related outcomes.

Methods: Adults 18 years and older with radiologically confirmed FPD between 2004 and 2024 were identified from institutional databases. Controls without FPD were matched 1:2 by age, sex, body mass index, and smoking status. Patients with excessive alcohol intake, previous pancreatitis, pancreatic cancer, surgery, cystic fibrosis, or prolonged steroid/antiviral use were excluded. Fat content in the pancreas and liver, as well as subcutaneous and visceral fat areas, were measured using iNtuition software on noncontrast computed tomography scans.

Results: We included 82 FPD patients and 164 matched controls (median age 65 years; 55% women; median body mass index 32). Subcutaneous and hepatic fat were similar between groups, but intrapancreatic fat deposition was markedly higher in FPD patients (26.8% vs 4.9%, P < 0.001). Over a mean 4-year follow-up, FPD patients had significantly higher rates of acute pancreatitis (12% vs 1.2%, P < 0.001), chronic pancreatitis (6.1% vs 0.6%, P = 0.017), pancreatic cysts (34.1% vs 4.9%, P < 0.001), and pancreatic cancer (1.6% vs 0%, P = 0.012). Extrapancreatic cancer incidence did not differ.

Discussion: FPD is associated with an increased risk of pancreatic cancer, acute pancreatitis, chronic pancreatitis, and incidental pancreatic cysts, independent of obesity or hepatic steatosis, suggesting a potentially causative role of FPD in the pathogenesis of exocrine pancreatic diseases.

脂肪性胰腺疾病和未来外分泌胰腺疾病的风险:一项美国匹配队列研究
背景:脂肪性胰腺疾病(FPD)以胰腺内脂肪过多为特征,通常在影像学上偶然发现。尽管已确认与代谢有关,但其临床意义尚不清楚。需要来自大型、特征明确的美国队列的更细粒度的数据来阐明其相关性。本研究量化了胰腺内脂肪沉积(IPFD),并评估了其自然历史和相关结果。方法:从机构数据库中确定2004年至2024年间放射学证实的FPD成人≥18岁。没有FPD的对照组按年龄、性别、BMI和吸烟状况按1:2匹配。排除了过量饮酒、既往胰腺炎、胰腺癌、手术、囊性纤维化或长期使用类固醇/抗病毒药物的患者。使用iNtuition®软件在非对比CT扫描上测量胰腺和肝脏以及皮下和内脏脂肪区域的脂肪含量。研究结果:我们纳入了82例FPD患者和164名匹配的对照组(中位年龄65岁;55%为女性;中位BMI为32)。两组间皮下脂肪和肝脏脂肪相似,但FPD患者的IPFD明显更高(26.8% vs. 4.9%)。解释:FPD与胰腺癌、急性胰腺炎、慢性胰腺炎和偶然胰腺囊肿的风险增加相关,独立于肥胖或肝脏脂肪变性,提示FPD在外分泌胰腺疾病的发病机制中具有潜在的致病作用。
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来源期刊
American Journal of Gastroenterology
American Journal of Gastroenterology 医学-胃肠肝病学
CiteScore
11.40
自引率
5.10%
发文量
458
审稿时长
12 months
期刊介绍: Published on behalf of the American College of Gastroenterology (ACG), The American Journal of Gastroenterology (AJG) stands as the foremost clinical journal in the fields of gastroenterology and hepatology. AJG offers practical and professional support to clinicians addressing the most prevalent gastroenterological disorders in patients.
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