Relationship of fat in the pancreas with cardiovascular disease: A systematic review and meta-analysis.

Background: General adiposity is a well-known risk factor for cardiovascular disease. By contrast, the interconnection between high intra-pancreatic fat deposition and cardiovascular disease has been scantily investigated. This field-wide systematic review aimed to map the available evidence on cardiovascular disease according to the fat content of the pancreas.

Methods: A literature search using two electronic databases (MEDLINE and Embase) was conducted independently by two reviewers. Studies reporting on the association between intra-pancreatic fat deposition and cardiovascular disease in humans were included. Where meta-analysis was possible, data were pooled using a random-effects method.

Results: A total of 16 studies published between 1966 and 2024 were included. The most credible findings across domains of heart diseases, diseases of arteries, arterioles, and capillaries, as well as subclinical atherosclerosis provided supportive evidence of a positive relationship between high intra-pancreatic fat deposition and cardiovascular disease. Meta-analysis showed that high intra-pancreatic fat deposition was significantly associated with increased aortic intima-media thickness (mean difference: 0.19 mm; 95% confidence interval: 0.12-0.26; p < 0.001), increased carotid intima-media thickness (mean difference: 0.06 mm; 95% confidence interval: 0.03-0.08; p < 0.001), and increased vascular stiffness (mean difference: 167 cm/s; 95% confidence interval: 81-254; p < 0.001).

Conclusion: The accumulated evidence from more than 7000 people demonstrates a tangible connection of intra-pancreatic fat deposition with cardiovascular disease (especially, subclinical atherosclerosis). Purposely designed investigations of high intra-pancreatic fat deposition as an additional risk factor (independent of general adiposity) for cardiovascular disease are warranted.