The associations between pancreatic fat infiltration and its combination with the triglyceride glucose index and the risk of coronary calcification: A multicenter study.

Introduction: Intrapancreatic fat deposition is related to insulin resistance and type 2 diabetes mellitus. However, the association between intrapancreatic fat deposition and coronary artery disease has not been well studied. In this study, we investigated the associations between intrapancreatic fat deposition alone or in combination with triglyceride glucose index (TYG) and the risk of coronary artery calcification (CAC) in a general population.

Methods: A total of 9479 participants who underwent computed tomography (CT) scans for lung cancer screening from 2018-2020 were included in this study. The TYG index was calculated via the following equation: Ln[fasting glucose (mg/dL)×fasting TG (mg/dL)/2]. Pancreatic CT attenuation was used as a marker of intrapancreatic fat deposition. CAC was evaluated on noncardiogram-gated chest CT.

Results: CAC was detected in 2447 of 9479 participants. The prevalence of CAC was significantly lower in subjects with high pancreatic CT attenuation (37.8% in the first quartile (Q1) vs 17.8% in the fourth quartile (Q4), p < 0.001). Pancreatic CT attenuation was associated with the occurrence of CAC (odds ratio (OR) = 0.82, 95% confidence interval (CI): 0.69-0.97, Q4 vs Q1). The area under the curve of the combination of pancreatic CT attenuation and the TYG index was significantly greater than that of TYG and pancreatic CT attenuation alone in identifying CACs (0.646 vs 0.596 and 0.612, p < 0.001).

Conclusions: Intrapancreatic fat deposition was associated with CAC, and the combination of pancreatic CT attenuation and the TYG index performed better than TYG or pancreatic CT attenuation alone in identifying CACs.