From the Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Rd, Taipei, Taiwan (C.S.H., P.H.T., C.H.T., C.C.C., W.C.L., Y.C.L., H.M.C., H.J.L., W.S.Y., M.S.W.); Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan (C.H.T., W.S.Y.); and Clinical Outcome Research and Training Center and Cardiovascular Center, China Medical University Hospital, College of Medicine, China Medical University, Taichung, Taiwan (M.F.C.).
Radiology. 2018 Jun;287(3):853-863. doi: 10.1148/radiol.2018170331. Epub 2018 Apr 3.
Purpose To evaluate the association between increased pancreatic echogenicity (IPE) and the risk of glycemic progression and incident diabetes. Materials and Methods This retrospective study was approved by the institutional review board, with waiver of informed consent. Consecutive individuals who had undergone abdominal ultrasonography as part of a health examination at a tertiary hospital between January 2005 and December 2011 were included. IPE was defined as increased echogenicity of the pancreas compared with that of the left lobe of liver. Glycemic progression was defined as the development of new prediabetes or diabetes in normoglycemic participants or as new diabetes in prediabetic participants during the follow-up period (median, 3.17 years; interquartile range, 2.01-4.67 years). The occurrence of incident diabetes, defined as a new diagnosis of diabetes during follow-up, was also analyzed. Results Mean age of the 32 346 participants was 50.4 years ± 12.2, and 48% (15 489 of 32 346) were female. The prevalence of IPE and nonalcoholic fatty liver disease (NAFLD) was 8.4% (2720 of 32 346) and 41.4% (13 389 of 32 346), respectively. A total of 8856 participants were included in the follow-up analysis. During the 29 819.2 person-years of follow-up, 1217 (13.7%) and 449 (5.1%) of the 8856 participants developed glycemic progression and new diabetes, respectively. IPE was associated with more glycemic progression (hazard ratio, 1.54; 95% confidence interval: 1.23, 1.92; P < .001) and incident diabetes (hazard ratio, 1.49; 95% confidence interval: 1.05, 2.11; P = .024) after adjustment for confounders, HbA concentration, and NAFLD. Conclusion Increased pancreatic echogenicity is associated with deteriorating glycemic parameters and higher risk of glycemic progression and incident diabetes, independent of HbA concentration and NAFLD. RSNA, 2018 Online supplemental material is available for this article.
评估胰腺回声增强（IPE）与血糖恶化风险和新发糖尿病之间的关联。
本回顾性研究经机构审查委员会批准，豁免知情同意。纳入 2005 年 1 月至 2011 年 12 月期间在一家三级医院进行健康检查时接受过腹部超声检查的连续个体。IPE 定义为与左肝叶相比，胰腺回声增强。血糖恶化定义为在随访期间，正常血糖参与者出现新的糖尿病前期或糖尿病，或糖尿病前期参与者出现新的糖尿病（中位数，3.17 年；四分位距，2.01-4.67 年）。还分析了新发糖尿病（定义为随访期间新诊断的糖尿病）的发生情况。
32346 名参与者的平均年龄为 50.4 岁±12.2 岁，48%（15489/32346）为女性。IPE 和非酒精性脂肪性肝病（NAFLD）的患病率分别为 8.4%（2720/32346）和 41.4%（13389/32346）。共有 8856 名参与者纳入随访分析。在 29819.2 人年的随访期间，8856 名参与者中有 1217 名（13.7%）和 449 名（5.1%）分别发生血糖恶化和新发糖尿病。校正混杂因素、糖化血红蛋白浓度和 NAFLD 后，IPE 与更多的血糖恶化（危险比，1.54；95%置信区间：1.23，1.92；P<0.001）和新发糖尿病（危险比，1.49；95%置信区间：1.05，2.11；P=0.024）相关。
IPE 与血糖参数恶化以及血糖恶化和新发糖尿病风险增加相关，独立于糖化血红蛋白浓度和 NAFLD。RSNA，2018 在线补充材料可从本文获得。
