Burden of Intrapancreatic Fat Deposition in Type 2 Diabetes and the Role of Obesity: A Systematic Review and Meta-Analysis.

IF 17 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Current Obesity Reports Pub Date : 2026-05-21 DOI:10.1007/s13679-026-00718-3

Hyun Hee Sul, Saeed Ahmad, Pojsakorn Danpanichkul, Alessandro Mantovani, Matheus Souza, Maxim S Petrov

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Abstract

Background: Growing evidence supports a role for high intrapancreatic fat deposition (IPFD) in the pathogenesis of type 2 diabetes mellitus (T2DM); however, the magnitude of this association and the extent to which it is influenced by body mass index (BMI), liver fat content (LFC), and age remain uncertain.

Objective: To quantitatively evaluate IPFD measured by magnetic resonance imaging (MRI) in individuals with T2DM and to investigate study-level factors contributing to between-study variability.

Methods: We systematically searched PubMed and Embase for observational studies comparing MRI-measured IPFD in individuals with T2DM versus non-diabetic controls, excluding studies in which IPFD quantification was performed using AI-based models. Pooled standardized mean differences (SMDs) were estimated using a restricted maximum likelihood approach with Hartung-Knapp adjustment. Heterogeneity was explored through subgroup, meta-regression, and sensitivity analyses.

Results: Thirty studies (n=3,980) were included. Individuals with T2DM had significantly higher IPFD than non-diabetic controls (SMD 1.13, 95% CI 0.74 to 1.51), with no significant differences when stratified by pancreatic region, MRI technique, geographic region, sample size, and risk of bias. In multivariable models, BMI remained the only consistent moderating covariate, and the excess IPFD in T2DM persisted after adjusting for BMI, LFC, and age (intercept=0.797, p=0.010, false discovery rate-adjusted p=0.018). Advanced heterogeneity exploration identified no structural outliers, and the pooled effect size remained consistent across multiple sensitivity analyses.

Conclusion: T2DM is associated with substantially higher MRI-quantified IPFD, independent of study-level differences in BMI, LFC, and age. Although causality cannot be inferred, these findings support the hypothesis that IPFD may be involved in the underlying mechanism of T2DM. They also suggest that high IPFD could represent a metabolic hallmark, with potential implications for risk stratification and therapeutic targeting.

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2型糖尿病胰腺内脂肪沉积负担和肥胖的作用：一项系统综述和荟萃分析

背景：越来越多的证据支持高胰腺内脂肪沉积（IPFD）在2型糖尿病（T2DM）发病机制中的作用；然而，这种关联的程度及其受体重指数（BMI）、肝脏脂肪含量（LFC）和年龄影响的程度仍不确定。目的：定量评价磁共振成像（MRI）测量T2DM患者的IPFD，并探讨研究水平上影响研究间变异性的因素。方法：我们系统地检索了PubMed和Embase中比较T2DM患者与非糖尿病对照者mri测量的IPFD的观察性研究，排除了使用基于ai的模型进行IPFD量化的研究。采用Hartung-Knapp平差的限制性最大似然方法估计了综合标准化平均差（SMDs）。通过亚组、元回归和敏感性分析探讨异质性。结果：纳入30项研究（n= 3980）。T2DM患者的IPFD明显高于非糖尿病对照组（SMD 1.13, 95% CI 0.74 - 1.51），但按胰腺区域、MRI技术、地理区域、样本量和偏倚风险分层时，IPFD无显著差异。在多变量模型中，BMI仍然是唯一一致的调节协变量，在调整BMI、LFC和年龄后，T2DM患者的过量IPFD仍然存在（截距=0.797,p=0.010，假发现率调整后p=0.018）。先进的异质性探索未发现结构异常值，并且在多个敏感性分析中合并效应大小保持一致。结论：T2DM与mri量化IPFD显著升高相关，与BMI、LFC和年龄的研究水平差异无关。虽然因果关系无法推断，但这些发现支持IPFD可能参与T2DM潜在机制的假设。他们还认为，高IPFD可能代表一种代谢标志，对风险分层和治疗靶向有潜在的影响。

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来源期刊

Current Obesity Reports Medicine-General Medicine

CiteScore

16.40

自引率

1.10%

发文量

期刊介绍： The main objective of Current Obesity Reports is to provide expert review articles on recent advancements in the interdisciplinary field of obesity research. Our aim is to offer clear, insightful, and balanced contributions that will benefit all individuals involved in the treatment and prevention of obesity, as well as related conditions such as cardiovascular diseases, endocrine disorders, gynecological issues, cancer, mental health, respiratory complications, and rheumatological diseases. We strive to redefine the way knowledge is expressed and provide organized content for the benefit of our readership.