Fatty pancreas: Current insights and future perspectives.

Objectives/Goals: Unhealthy lifestyle habits may increase medical students’ risk for metabolic dysfunction-associated fatty liver disease (MAFLD) and non-alcoholic fatty pancreatic disease (NAFPD). This study aims to investigate how these lifestyle factors affect liver and pancreas health in preclinical medical students using diagnostic ultrasound imaging. Methods/Study Population: Using diagnostic ultrasound imaging, we propose a research study to evaluate the anatomical changes of the liver and pancreas associated with lifestyle among medical students in UCC. Forty-two (42) medical students from the Central University of the Caribbean who are in their preclinical years will be recruited to perform an abdominal ultrasound. To measure the diameter of the right liver lobe, we will employ the craniocaudal measurement method established by Riestra. et al. (2018). The parameter established by Rumack et al. (2011) will be utilized to assess liver texture and categories by Lee JS et al. (2009) to pancreas fat infiltration grades. Results/Anticipated Results: This study expects to reveal a significant correlation between the lifestyles of preclinical medical students and the health of their liver and pancreas, particularly in size and texture. We anticipate identifying specific lifestyle factors – such as dietary habits and physical activity levels – that contribute to the prevalence of hepatic and pancreatic steatosis. Additionally, we expect to highlight the need for targeted interventions to promote healthier lifestyles among medical students to mitigate risks associated with MAFLD and NAFPD. Discussion/Significance of Impact: This study is significant for monitoring changes in liver and pancreas health, preventing complications, and improving health quality while reducing future costs. It may guide the creation of tailored wellness programs for medical students, enhancing their well-being and contributing to better healthcare practices and educational strategies.

Background Lipocalin-2 (LCN2) is a 25-kDa secretory protein with great importance as a sensitive and specific screening and diagnostic biomarker for hepatic inflammation, acute hepatic injury, hepatic cancer, and radiation-induced early phase hepatic damage and lipid abnormalities. However, little is known about LCN2's functions in the homeostasis and metabolism of hepatic lipids or in the development of steatosis as well as its actual role in the event of inflammation. Aim and Objectives To establish a correlation between the levels of lipocalin as a useful biomarker with increasing severity of steatosis in NAFLD and NAFPD patients. Subjects and Methods This was observational prospective case–control study, was conducted at Hepatology Unit of Ain Shams University Hospital on 50 patients diagnosed with NAFPD and 50 healthy age and sex-matched volunteers without NAFPD during a period of 6 months. All patients were subjected to; Full history taking and thorough clinical examination, Anthropometric measurements, Laboratory investigations, and abdominal ultrasonography. Result There was a significant Positive correlation between Lipocalin 2, BMI, LDL (mg/dL), Cholesterol (mg/dL), Insulin (μU/mL) and HOMA-IR in patient group(P-value ≤ 0.001), Conclusion; lipocalin-2 is a good blood biomarker for detection of hepatic and Pancreatic steatosis. The lipocalin levels increase with increasing severity of steatosis. In addition to this, lipocalin will be useful for early diagnosis of NAFLD, NAFPD and convenient to do with other blood tests. The early intervention may prevent high morbidity and mortality and to manage the disease properly.

Background: Recently, the coexistence of chronic hepatitis B (CHB) and metabolic associated fatty liver disease (MAFLD) has garnered increasing attention. Nevertheless, the frequency of MAFLD among individuals with HBV infection and its relationship with pancreatic steatosis remain subjects of ongoing debate. Aims of study: This study aims to investigate the prevalence of MAFLD, hepatic fibrosis, and pancreatic steatosis in obese versus lean patients with CHB, including both treatment-naive individuals and those receiving first-line nucleos(t)ide analogue therapy. Patients and Methods: This cross-sectional study encompassed 217 CHB participants were placed into two groups in accordance to their BMI. Hepatic steatosis (HS) and stiffness were determined via transient elastography, while the presence of pancreatic steatosis (PS) was evaluated via ultrasonography. Results: Our findings revealed that the frequency of significant HS among participants with CHB was 37.3%, which is less than that reported in the general Egyptian population. PS was observed in 64.1% of overweight/obese patients and 25.8% of lean patients. HS demonstrated a positive correlation with age, BMI, T2DM, pancreatic steatosis, and dyslipidemia, and an inverse association with HBV DNA levels (p < 0.05), but was not significantly associated with hepatic fibrosis (p > 0.05). Multivariate logistic regression analysis determined diabetes mellitus, pancreatic steatosis, increased BMI or waist circumference, elevated cholesterol and triglyceride levels, and reduced HDL levels as independent determinants with hepatic steatosis. Conclusion: Our data suggest that the frequency of HS is decreased in participants with CHB than in the general Egyptian population. DM, fatty pancreas, increase in BMI or waist circumference, elevated level of cholesterol and triglycerides and low level of HDL were independent indicators for hepatic steatosis. However, the coexistence of HS with HBV did not show association with developing fibrosis.

Background Fatty pancreas results from excessive ectopic fat accumulation represents a global health problem recently. Objectives To determine the prevalence of fatty pancreas among non alcoholic fatty liver patients and to find out the main risk factors for fatty pancreas. Patients and Methods A descriptive prospective observational study conducted at Kurdistan Center for Gastroenterology and Hepatology (KCGH) in Sulaimani governorate through the period from 1st April, 2014 to 31st of April, 2015 on convenient sample of 75 non-alcoholic fatty liver patients. The data was collected by researcher through direct interview and filling of questionnaire included demographic data, weight, height, smoking, drug history, laboratory results of Gamma-Glutamyl transferase (GGT) and lipid profile and ultrasound results of pancreas. Results The prevalence of fatty pancreas among patients with non alcoholic fatty liver diseases was 49.3%. Fatty pancreas was significantly predominant among elderly patients (p=0.03). Significant higher levels of triglycerides (p=0.03) and GGT (p=0.02) were found among fatty pancreas patients. High density lipoproteins level was significantly lower among fatty pancreas patients (p=0.04). Conclusion About half of patients with non alcoholic fatty liver diseases had non alcoholic fatty pancreas;The main risk factors for fatty pancreas were elderly age, male gender, obesity and abnormal lipid profile.

Impact of pancreatic steatosis on risk of Post-ERCP pancreatitis: Systematic review and meta-analysis.

Стаття присвячена стеатозу підшлункової залози (ПЗ) у дітей — патологічному стану, що характеризується акумуляцією жиру в ПЗ. В огляді проаналізовані дані, що стосуються факторів ризику, можливостей діагностики і терапії стеатозу ПЗ. Продемонстровано, що провідними чинниками, асоційованими з розвитком стеатозу ПЗ, вважаються ожиріння і метаболічний синдром. Охарактеризовані переваги неінвазивних візуалізаційних методів, таких як трансабдомінальне ультразвукове дослідження, комп’ютерна томографія, магнітно-резонансна томографія та ендоскопічне ультразвукове дослідження в діагностиці стеатозу ПЗ у дітей. Представлені й обґрунтовані основні напрямки терапії стеатозу ПЗ: модифікація способу життя, корекція дисліпідемії та порушень вуглеводного обміну, екзокринної недостатності. Для написання огляду здійснювався пошук інформації з використанням баз даних Scopus, Web of Science, MedLine, PubMed, Google Scholar, CyberLeninka, РІНЦ за ключовими словами: «стеатоз підшлункової залози», «неалкогольна жирова хвороба підшлункової залози», «діти».

To develop an animal mode of alcoholic pancreatic steatosis, female Wistar rats were pair fed liquid diets, containing ethanol as 36% of calories or an isocaloric amount of carbohydrate for 3 weeks. Electron microscopic examination showed lipid vesicles localized principally at the bases of pancreatic acinar cells in the ethanol-fed rats. Ethanol feeding significantly increased pancreatic content of cholesteryl ester without changing levels of other lipids. Ethanol feeding enhanced labeled acetate, palmitate, oleate, and linoleate incorporation into cholesteryl ester. Therefore, increased esterification of cholesterol may, in part, explain the observed accumulation of cholesteryl ester.

The aim of this study is to determine the presence of fatty liver and pancreatic steatosis in individuals diagnosed with Chronic Hepatitis B (CHB), Chronic Hepatitis C (CHC), and Wilson's Disease (WD) and to evaluate the relationship between the presence of fatty liver and pancreatic steatosis and laboratory parameters. Forty-eight CHB, fifty-six CHC, and thirty-five WD patients were included in the study. Pancreatic steatosis was measured by three methods: steatosis according to the mean pancreas value, steatosis according to the pancreas/spleen difference value, and steatosis according to the pancreas/spleen density ratio. Hepatic steatosis was measured by noncontrast CT using multi-site attenuation sampling and the Liver Attenuation Index (LAI); steatosis was graded according to predefined LAI cut-offs. Fatty liver and pancreatic steatosis were graded as Grade 1, 2, or 3. Certain laboratory parameters of the patients were also retrospectively reviewed. In 69.1% of all patients, grade 1 fatty liver disease was present. Pancreatic steatosis was absent in 50.3% of patients according to the mean pancreas value, 63.3% according to the pancreas/spleen difference, and 61.9% according to the pancreas/spleen density ratio. Fatty liver disease was positively correlated with high Erythrocyte Sedimentation Rate (ESR) (r=0.255, p=0.002) and Alanine Transaminase (ALT) (r=0.180, p=0.034). ESR (p=0.025) and urea level (p=0.024) were found to be significantly higher in the group with steatosis according to the mean pancreas value. According to the group with steatosis based on the pancreas/spleen density ratio, globulin level was significantly higher (p=0.038). The rates of steatosis according to the pancreas mean value (p=0.003) and the pancreas/spleen density ratio (p=0.039) were significantly more advanced in CHC patients compared with the other patient groups. There was no statistically significant difference between the stage of fatty liver and the stage of fatty pancreas (p>0.05). Although fatty liver and pancreatic steatosis are considered similar pathologies, our findings suggest that these two conditions should not be considered interchangeable. Further studies with larger samples may be useful to better demonstrate the correlation between the two conditions and the investigated parameters.

Fat accumulation in the pancreas, defined as fatty pancreas, is usually an incidental finding during transabdominal ultrasound examination. Fatty pancreas without any significant alcohol consumption is defined as non-alcoholic fatty pancreas disease. Even though its clinical impact is still largely unknown, hypothetically the disease progression could lead to chronic pancreatitis and possibly pancreatic cancer development. Recently, metabolic problems such as diabetes, central obesity, fatty liver, and dyslipidaemia have been considered important risk factors related to non-alcoholic fatty pancreas disease and pancreatic cancer; however, the exact mechanism is not yet fully understood. Early detection and screening for pancreatic cancer in clinical practice is troublesome because of the non-specific symptoms, anatomical location, accuracy of biomarkers in clinical practice, and high risk of radiation and contrast agent exposure from imaging study. Endoscopic ultrasound is still considered the best method for pancreas evaluation and for the screening and diagnosis of pancreatic cancer. However, there is still much debate regarding its cost, availability, and the training experience of the operator.

Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is a frequent and clinically significant complication. Pancreatic steatosis (PS), an increasingly common imaging finding associated with obesity, metabolic syndrome, and diabetes, may predispose the pancreas to injury during ERCP; however, its association with the risk of PEP remains uncertain. To systematically evaluate the association between pancreatic steatosis and the risk and severity of PEP. Systematic review and meta-analysis were conducted following PRISMA guidelines. MEDLINE, Embase, and Cochrane databases were searched through May 2025 for studies comparing PEP incidence in patients with and without PS. Pooled relative risks (RRs) were calculated using random-effects models. Subgroup analyses examined the impact of demographic factors, procedural variables, and diagnostic indications. Four studies involving 2108 patients were included. PS was associated with a significantly increased risk of PEP [Relative Risk (RR): 2.69; 95% confidence interval: 1.86-3.90; p = 0.32), with an incidence of 12% in patients with PS compared to 6% in those without. PS was also linked to higher risk of mild (RR: 2.25), moderate (RR: 4.73), and severe PEP (RR: 4.54). Compared to non-PS, patients with PS had higher prevalence of diabetes (RR: 1.41) and female sex (RR: 1.15). No significant differences in procedural variables or diagnostic indications were observed between the PS and non-PS groups. Pancreatic steatosis is associated with an increased risk and severity of PEP. Further high-quality prospective studies are warranted to validate this association and determine whether PS should be incorporated into pre-procedural risk stratification and targeted preventive strategies.

PurposeThis study investigated risk factors for hyperechoic pancreas (HP) on ultrasonography (US) according to HP severity.MethodsBetween December 2008 and February 2014, 1,459 subjects who underwent abdominal US as part of health examinations were retrospectively included. Two radiologists assessed and categorized the severity of HP as normal, mild, moderate, and severe. Subjects were allocated to two groups as follows: fatty pancreas 1 (FP1; mild to severe HP) and fatty pancreas 2 (FP2; moderate to severe HP). Clinico-metabolic parameters such as the body mass index and blood test profile of subjects with normoglycemia and prediabetes/diabetes were compared (normal vs. FP1; normal or mild HP vs. FP2). Logistic regression analysis was used to evaluate the associations between HP, nonalcoholic fatty liver disease (NAFLD), and diabetes/prediabetes with adjustment for clinico-metabolic parameters.ResultsOf the 1,459 subjects, 71.2% and 40.4% showed HP and NAFLD on US, respectively. Normoglycemia and prediabetes/diabetes were present in 74.3% and 25.7% of subjects, respectively. Univariable analysis revealed that all the clinico-metabolic parameters were significantly associated with HP (all P<0.05). In the adjusted multivariable analysis, prediabetes/diabetes, NAFLD, age, and body mass index were significantly associated with HP with the FP1 and FP2 criteria. The independent factor with the strongest association with HP was NAFLD using the FP1 criterion (odds ratio [OR], 7.93; P<0.001) and prediabetes/diabetes using the FP2 criterion (OR, 6.96; P<0.001).ConclusionNAFLD and prediabetes/diabetes were associated with US-diagnosed HP. Moderate to severe HP was a better predictor of prediabetes/diabetes, suggesting that evaluating HP severity may be useful in clinical practice.

Obesity induces metabolic disorders such as type 2 diabetes, hypertension, and cardiovascular diseases and has become a global health concern. Recent studies imply that fat accumulation in nonadipose tissue correlates with metabolic disorders. However, there are no suitable animal models to evaluate this phenomenon. This study investigated the characteristics of metabolic disorders found in cotton rat (Sigmodon hispidus). Blood biochemical examinations revealed that cotton rats, predominantly males, developed hyperinsulinemia, hyperglycemia, and dyslipidemia when fed a normal diet. The islets increased in size through β-cell hyperplasia, which was associated with serum insulin level in both sexes, strongly indicating insulin resistance. In male cotton rats, oxidative stress was observed in β cells, and macrophage infiltration into the visceral white adipose tissue was reported, both of which were associated with serum insulin level without visceral obesity. In contrast, female cotton rats developed hyperinsulinemia without histopathological changes that were reported in males. Adipocytes were found to be accumulated in the pancreas but not in the liver of both sexes during aging. Pancreatic fat accumulation was associated with the serum insulin level only in females. Taken together, cotton rats developed metabolic disorders associated with visceral fat inflammation in the absence of obesity. In addition, pancreatic ectopic fat may also be related to the early stages of these conditions. Thus, the cotton rat may serve as a novel and useful model for metabolic disorders characterized by visceral adipose inflammation and ectopic fat accumulation in the pancreas without obesity.

The number of people who die from kidney disease every year has risen over the past decade and is now estimated at 5 million to 10 million worldwide. The increase in rates of obesity — along with associated rates of type 2 diabetes, hypertension, and cardiovascular disease — has principally driven the elevated mortality. More than 660,000 Americans have reached the point of requiring intervention for end-stage kidney disease, with 468,000 receiving dialysis and more than 193,000 undergoing kidney transplantation, leading to a major public health and economic burden.1 Hence, the development of new treatments that may prevent or delay .

ObjectivesThe objective of this study was to identify factors associated with adolescent obesity, as well as any new factors that correlated with a change in the rate of obesity over time.MethodsThe study used 5-yearly data collected by the Korea Youth Risk Behavior Survey starting from the year 2006 up until 2021 (data from 2nd, 7th, 11th, and 17th surveys were analyzed). Factors such as demographics, dietary factors, health behavioral factors, and mental health factors were studied. All data were analyzed using IBM SPSS 27.0, employing chi-square tests and multiple logistic regression analysis.ResultsThis study included data from a total of 255,200 participants. Factors contributing to obesity varied with time. Over the survey duration of 15 years, low academic achievement, parents with low levels of education, low frequency of fruit consumption, low frequency of fast food intake, long periods of being seated, and high levels of stress were significantly associated with a high rate of obesity. Factors that showed a new correlation with an increase in obesity rates included living with single parents, low frequency of muscle strengthening exercises, and experiencing intense sadness and despair in the past year. Factors that were correlated with a change in obesity rates over time included household economic status, frequency of carbonated beverage consumption, frequency of intense physical activity, and frequency of alcohol consumption. Breakfast intake and smoking were not significantly associated with obesity rates in the 15-year period.ConclusionsWhile several factors associated with obesity remained consistent over time, several new factors have emerged in response to social, economic, and environmental changes contributed to a change in obesity rate over time. Therefore, to prevent and manage adolescent obesity, continuous research into the new emergent factors contributing to obesity is needed.

Nutritional factors, especially the protein and fat content of the diet, may change pancreatic morphology after ethanol induced injury. This study was performed to delineate the combined effects of a low fat diet and longterm ethanol ingestion on the rat pancreas. Male Sprague-Dawley rats were maintained with five different diets for 12 weeks and the pancreas removed on the day they were killed. Rats fed a very low fat diet without ethanol (5% of total calories as lipid) developed malnutrition, pancreatic steatosis, and reduction in zymogen granules content. Animals fed a 35% lipid diet with ethanol also developed pancreatic steatosis but changes in zymogen granules content were not detected. Both malnutrition and longterm ethanol consumption increased pancreatic cholesterol ester content, and their effects were additive. Pancreatic steatosis was accompanied with hypercholesterolaemia. Amylase, lipase, and cholesterol esterase content were reduced in malnourished rats; but longterm ethanol ingestion, regardless of the nutritional state, increased lipase content and decreased amylase. It is suggested that high serum cholesterol concentrations and increased pancreatic lipase activity could cause accumulation of cholesterol esters in acinar cells. Fat accumulation in the pancreas has been reported as the earliest histopathological feature in alcoholic patients and may be responsible for cytotoxic effects on the acinar cells at the level of the cell membrane. Although it is difficult to extrapolate results in this animal study to the human situation, the results presented in this work might explain the higher incidence of pancreatitis is malnourished populations as well as in alcoholic subjects that is reported in dietary surveys.