Division of Pediatric Specialties, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland.
J Pediatr Gastroenterol Nutr. 2012 Jun;54(6):720-6. doi: 10.1097/MPG.0b013e318244a685.
Little is known about pancreatic fat accumulation and its possible associations with metabolic syndrome (MetS) and glucose metabolism. The aim of the present study was to quantify pancreatic fat fraction (PFF) in lean and obese adolescents and explore its relation to metabolic parameters.
We recruited 25 lean and 24 obese adolescents. PFF and visceral adipose tissue (VAT) were determined using magnetic resonance imaging. We measured blood pressure, fasting glucose, insulin, liver enzymes, leptin, and lipid levels. Obese subjects underwent an oral glucose tolerance test.
PFF was significantly higher in obese than in lean subjects (4.8±1.2 vs 3.6±0.9; P<0.001) and was associated with VAT, γ-glutamyltransferase, triglycerides, high-density lipoprotein cholesterol, leptin concentrations, and MetS (P<0.05 for all). None of the obese subjects had glucose intolerance, but when adjusted for VAT, the following 3 parameters correlated negatively with PFF: fasting and 30- minute and 120-minute insulin levels. We divided subjects into 3 groups: group I, lean without MetS; group II, obese without MetS; and group III, obese with MetS, and observed that PFF increased gradually among groups (I: 3.56%±0.88%; II: 4.70%±1.06%; III: 5.34%±1.49%; P<0.001).
Obese adolescents accumulate fat in the pancreas. PFF correlates with the presence of MetS. Even in the absence of glucose intolerance, pancreatic fat deposition is associated with impaired insulin response to glucose overload. This suggests that β-cell dysfunction may already be present in nondiabetic obese adolescents, mirroring what has been shown in adults, and that pancreatic fat accumulation may participate in obesity-associated pancreatic endocrine dysfunction.
人们对胰腺脂肪堆积及其与代谢综合征（MetS）和葡萄糖代谢的可能关联知之甚少。本研究旨在定量检测瘦人和肥胖青少年的胰腺脂肪分数（PFF），并探讨其与代谢参数的关系。
我们招募了 25 名瘦人和 24 名肥胖青少年。使用磁共振成像（MRI）测定 PFF 和内脏脂肪组织（VAT）。我们测量血压、空腹血糖、胰岛素、肝酶、瘦素和血脂水平。肥胖受试者进行口服葡萄糖耐量试验。
肥胖组的 PFF 明显高于瘦组（4.8±1.2 比 3.6±0.9；P<0.001），且与 VAT、γ-谷氨酰转移酶、甘油三酯、高密度脂蛋白胆固醇、瘦素浓度和 MetS 相关（所有 P<0.05）。没有肥胖受试者存在葡萄糖耐量异常，但调整 VAT 后，以下 3 个参数与 PFF 呈负相关：空腹和 30 分钟及 120 分钟胰岛素水平。我们将受试者分为 3 组：I 组，瘦且无 MetS；II 组，肥胖但无 MetS；III 组，肥胖且有 MetS，并观察到 PFF 在各组中逐渐升高（I 组：3.56%±0.88%；II 组：4.70%±1.06%；III 组：5.34%±1.49%；P<0.001）。
肥胖青少年的胰腺会堆积脂肪。PFF 与 MetS 的存在相关。即使不存在葡萄糖耐量异常，胰腺脂肪沉积也与葡萄糖负荷后胰岛素反应受损相关。这表明β细胞功能障碍可能已经存在于非糖尿病肥胖青少年中，反映了在成人中已经观察到的情况，并且胰腺脂肪堆积可能参与肥胖相关的胰腺内分泌功能障碍。
