应用 EUS 对脂肪性胰腺进行前瞻性评估。

A prospective evaluation of fatty pancreas by using EUS.

机构信息

Division of Gastroenterology, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA.

出版信息

Gastrointest Endosc. 2011 May;73(5):987-93. doi: 10.1016/j.gie.2011.01.015.

DOI:10.1016/j.gie.2011.01.015

PMID:21521567

Abstract

BACKGROUND

Fatty liver is associated with obesity, diabetes, hyperlipidemia, and the metabolic syndrome. The pathophysiology of fatty pancreas is poorly understood, but it may be closely related to fatty liver.

OBJECTIVE

The aim of our study was to determine the prevalence of fatty pancreas and risk factors associated with its development.

DESIGN

Prospective, single center study.

SETTING

Tertiary-care academic medical center.

PATIENTS

This study involved 250 consecutive patients referred for EUS examination.

INTERVENTION

All patients undergoing EUS at our institution were prospectively identified. Information regarding demographics, tobacco use, alcohol use, blood test results, and comorbidities were collected before EUS. Pancreatic echogenicity was graded in comparison to the spleen at the time of EUS by using an a priori specified grading scheme.

MAIN OUTCOME MEASUREMENTS

Prevalence of fatty pancreas and factors associated with its development.

RESULTS

During the study period, 250 consecutive patients were prospectively enrolled. The prevalence of fatty pancreas was 27.8% (95% CI, 22.1-34.1). Fatty liver was seen in 22.6% of patients. Factors associated with fatty pancreas on univariate analysis were increasing body mass index (BMI) (P=.004), fatty liver (P<.0001), hyperlipidemia (P=.04), and the metabolic syndrome (odds ratio [OR] 3.13, P=.004). The presence of any metabolic syndrome components, that is, BMI≥30, hyperlipidemia, diabetes, or hypertension, increased the prevalence of fatty pancreas by 37% (OR 1.37, P=.01). Factors independently associated with fatty pancreas on multivariate analysis were increasing BMI (OR 1.05, P=.03) and fatty liver (OR 3.61, P<.001). We found no association between fatty pancreas and chronic pancreatitis or adenocarcinoma of the pancreas.

LIMITATIONS

Single institution study. All patients were referred for EUS, which limits generalizability. Lack of histological confirmation of pancreatic fat.

CONCLUSION

We found a strong association between fatty pancreas and the metabolic syndrome.

摘要

背景

脂肪肝与肥胖、糖尿病、高血脂和代谢综合征有关。胰腺脂肪变性的病理生理学知之甚少，但它可能与脂肪肝密切相关。

目的

本研究旨在确定胰腺脂肪变性的患病率及其发病的相关危险因素。

设计

前瞻性、单中心研究。

地点

三级保健学术医疗中心。

患者

本研究纳入了 250 例连续接受 EUS 检查的患者。

干预措施

在我们的机构中，所有接受 EUS 的患者均进行前瞻性识别。在进行 EUS 检查之前，收集了有关人口统计学、吸烟、饮酒、血液检查结果和合并症的信息。使用预先指定的分级方案，在 EUS 时将胰腺回声与脾脏进行比较，对胰腺回声进行分级。

主要观察指标

胰腺脂肪变性的患病率及其发病的相关因素。

结果

在研究期间，前瞻性纳入了 250 例连续患者。胰腺脂肪变性的患病率为 27.8%（95%CI，22.1%-34.1%）。22.6%的患者存在脂肪肝。单因素分析中与胰腺脂肪变性相关的因素包括体重指数（BMI）增加（P=.004）、脂肪肝（P<.0001）、高血脂（P=.04）和代谢综合征（优势比[OR]3.13，P=.004）。任何代谢综合征成分的存在，即 BMI≥30、高血脂、糖尿病或高血压，会使胰腺脂肪变性的患病率增加 37%（OR 1.37，P=.01）。多因素分析中与胰腺脂肪变性独立相关的因素包括 BMI 增加（OR 1.05，P=.03）和脂肪肝（OR 3.61，P<.001）。我们未发现胰腺脂肪变性与慢性胰腺炎或胰腺腺癌之间存在关联。