Uygun Ahmet, Kadayifci Abdurrahman, Demirci Hakan, Saglam Mutlu, Sakin Yusuf S, Ozturk Kadir, Polat Zulfikar, Karslioglu Yildirim, Bolu Erol
Division of Gastroenterology, Gulhane Military Medical Academy, Ankara, Turkey.
Division of Gastroenterology, Faculty of Medicine, University of Gaziantep, Gaziantep, Turkey.
Eur J Intern Med. 2015 Jan;26(1):37-41. doi: 10.1016/j.ejim.2014.11.007. Epub 2014 Dec 7.
Fatty pancreas (FP) is related to obesity, and may have some clinical implications on glucose metabolism. The frequency and importance of FP in patients with nonalcoholic steatohepatitis (NASH) are not clear. This study aimed to investigate: the frequency of FP in patients with NASH, and its effects on serum glucose parameters.
FP was detected and graded by transabdominal ultrasonography (USG) in patients with biopsy-proven NASH and healthy controls. Body Mass Index and waist circumference were recorded, and serum lipids, fasting serum glucose, HbA1c, OGTT 2-h, insulin level, insulin resistance, type 2 diabetes mellitus (DM) and prediabetes rates were detected.
Eighty-four subjects with NASH and 35 healthy controls were enrolled in the study. There was no FP in 41 (48.8%) of the NASH patients according to the study criteria. Forty-three of the NASH patients and 5 of the controls had different grades of fat in their pancreas (51.2% vs. 14%, p=0.001). The HbA1c and OGTT 2-h results were significantly higher in NASH patients with FP compared to those without FP (p=0.003 and p=0.018). The rates of both prediabetes and DM were also found to be significantly increased in NASH patients with FP (p=0.004). The mean waist circumference was higher in patients with FP (p=0.027). Grade of FP by USG showed no effect on study parameters in subgroup analysis.
FP is common in patients with NASH and increases the rate of prediabetes and DM. The coexistence of both NASH and FP has a further impact on glucose metabolism and DM frequency.
胰腺脂肪变性（FP）与肥胖相关，可能对糖代谢有一些临床影响。FP在非酒精性脂肪性肝炎（NASH）患者中的发生率及重要性尚不清楚。本研究旨在调查：NASH患者中FP的发生率及其对血清葡萄糖参数的影响。
通过经腹超声检查（USG）对经活检证实为NASH的患者和健康对照者进行FP检测及分级。记录体重指数和腰围，并检测血脂、空腹血糖、糖化血红蛋白、口服葡萄糖耐量试验2小时血糖、胰岛素水平、胰岛素抵抗、2型糖尿病（DM）及糖尿病前期发生率。
本研究纳入了84例NASH患者和35例健康对照者。根据研究标准，41例（48.8%）NASH患者无FP。43例NASH患者和5例对照者胰腺有不同程度的脂肪（51.2%对14%，p=0.001）。与无FP的NASH患者相比，有FP的NASH患者糖化血红蛋白和口服葡萄糖耐量试验2小时血糖结果显著更高（p=0.003和p=0.018）。还发现有FP的NASH患者糖尿病前期和DM的发生率也显著增加（p=0.004）。有FP的患者平均腰围更高（p=0.027）。在亚组分析中，USG检测的FP分级对研究参数无影响。
FP在NASH患者中常见，增加了糖尿病前期和DM的发生率。NASH和FP共存对糖代谢及DM发生率有进一步影响。
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