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胰腺脂肪变性与慢性胰腺炎、肥胖症和2型糖尿病的关联。

Association of Pancreatic Steatosis With Chronic Pancreatitis, Obesity, and Type 2 Diabetes Mellitus.

作者信息

Tirkes Temel, Jeon Christie Y, Li Liang, Joon Aron Y, Seltman Ted A, Sankar Meghana, Persohn Scott A, Territo Paul R

机构信息

Samuel Oschin Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA.

Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX.

出版信息

Pancreas. 2019 Mar;48(3):420-426. doi: 10.1097/MPA.0000000000001252.

Abstract

OBJECTIVE

The aim of this study was to determine the association of the pancreatic steatosis with obesity, chronic pancreatitis (CP), and type 2 diabetes mellitus.

METHODS

Patients (n = 118) were retrospectively identified and categorized into no CP (n = 60), mild (n = 21), moderate (n = 27), and severe CP (n = 10) groups based on clinical history and magnetic resonance cholangiopancreatography using the Cambridge classification as the diagnostic standard. Visceral and subcutaneous compartments were manually segmented, and fat tissue was quantitatively measured on axial magnetic resonance imaging.

RESULTS

Pancreatic fat fraction showed a direct correlation with fat within the visceral compartment (r = 0.54). Patients with CP showed higher visceral fat (P = 0.01) and pancreatic fat fraction (P < 0.001): mild, 24%; moderate, 23%; severe CP, 21%; no CP group, 15%. Patients with type 2 diabetes mellitus showed higher pancreatic steatosis (P = 0.03) and higher visceral (P = 0.007) and subcutaneous fat (P = 0.004). Interobserver variability of measuring fat by magnetic resonance imaging was excellent (r ≥ 0.90-0.99).

CONCLUSIONS

Increased visceral adipose tissue has a moderate direct correlation with pancreatic fat fraction. Chronic pancreatitis is associated with higher pancreatic fat fraction and visceral fat. Type 2 diabetes mellitus is associated with higher pancreatic fat fraction and visceral and subcutaneous adiposity.

摘要

目的

本研究旨在确定胰腺脂肪变性与肥胖、慢性胰腺炎(CP)和2型糖尿病之间的关联。

方法

回顾性纳入118例患者,根据临床病史和磁共振胰胆管造影,采用剑桥分类法作为诊断标准,将患者分为非CP组(n = 60)、轻度CP组(n = 21)、中度CP组(n = 27)和重度CP组(n = 10)。手动分割内脏和皮下区域,并在轴位磁共振成像上对脂肪组织进行定量测量。

结果

胰腺脂肪分数与内脏脂肪呈直接正相关(r = 0.54)。CP患者的内脏脂肪(P = 0.01)和胰腺脂肪分数更高(P < 0.001):轻度CP组为24%;中度CP组为23%;重度CP组为21%;非CP组为15%。2型糖尿病患者的胰腺脂肪变性更高(P = 0.03),内脏脂肪(P = 0.007)和皮下脂肪也更高(P = 0.004)。磁共振成像测量脂肪的观察者间变异性极佳(r≥0.90 - 0.99)。

结论

内脏脂肪组织增加与胰腺脂肪分数呈中度直接相关。慢性胰腺炎与更高的胰腺脂肪分数和内脏脂肪有关。2型糖尿病与更高的胰腺脂肪分数以及内脏和皮下肥胖有关。

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