Ulasoglu Celal, Tekin Zeynep Nilufer, Akan Kubra, Yavuz Arda
Department of Gastroenterology, Medeniyet University, Goztepe Education and Research Hospital, Istanbul, Turkey.
Department of Radiology, Medeniyet University, Goztepe Education and Research Hospital, Istanbul, Turkey.
Clin Exp Gastroenterol. 2021 Jun 11;14:269-275. doi: 10.2147/CEG.S317340. eCollection 2021.
To identify the correlation of nonalcoholic pancreatic steatosis (NAPS) with nonalcoholic fatty liver disease (NAFLD) in an outpatient group. Based on its metabolic and imaging properties, NAPS has been increasingly recognized in recent years; however, its interaction with NAFLD is still not clear.
In this cross-sectional observational study, 345 consecutive patients without any chronic illness who were referred to the senior radiologist for abdominal ultrasound (US) were included. The US report showed hepatic and pancreatic echogenicity. The patients' demographic, anthropometric, and laboratory data were collected from medical records.
Overall, NAPS and NAFLD were seen in 227 (65.8%) and 219 (63.5%) patients, respectively. Normal echogenicity was noted in 74 (21.4%) patients. Forty-four patients (12.8%) had steatotic liver without NAPS, 52 (15.1%) had steatotic pancreas without NAFLD, and 175 (50.7%) had steatosis in both organs. The discordance in steatosis grading between NAPS and NAFLD was 55.1%. Insulin resistance was present in 8.7, 26.7, 19, and 61.3% of patients with no steatosis, only NAFLD, only NAPS, and steatosis in both organs, respectively. Evident NAFLD and NAPS having grade 2 and 3 steatosis were present in 15.3% and 29.0% of the study group, respectively. Cholecystolithiasis was present in 6.8, 13.6, and 28.8% of patients with normal echogenic pancreas, only NAFLD, and only NAPS, respectively (p=0.01).
Based on the ultrasonographic, clinical, demographic, and anthropometric features of the included patients, we found that NAPS did not fully accompany nonalcoholic fatty liver. Despite severe pancreatic steatosis, more than a quarter of cases had normal liver echogenicity. Insulin resistance frequency was insignificantly higher in NAFLD than NAPS (p=0.694). The significantly higher frequency of cholecystolithiasis in NAPS needs further large-scale studies. The inconsistency of steatosis degree in NAPS and NAFLD in >50% cases may reflect differences in the pathophysiology of these two clinical entities.
确定门诊患者中非酒精性胰腺脂肪变性（NAPS）与非酒精性脂肪性肝病（NAFLD）之间的相关性。基于其代谢和影像学特征，近年来NAPS越来越受到认可；然而，其与NAFLD的相互作用仍不明确。
在这项横断面观察性研究中，纳入了345例连续的无任何慢性病且被转诊至资深放射科医生处进行腹部超声（US）检查的患者。超声报告显示肝脏和胰腺的回声。患者的人口统计学、人体测量学和实验室数据从病历中收集。
总体而言，分别有来自227例（65.8%）和219例（63.5%）患者中发现了NAPS和NAFLD。74例（21.4%）患者的回声正常。44例（12.8%）患者有脂肪变性的肝脏但无NAPS，52例（15.1%）患者有脂肪变性的胰腺但无NAFLD，175例（50.7%）患者两个器官均有脂肪变性。NAPS和NAFLD在脂肪变性分级上的不一致率为55.1%。无脂肪变性、仅有NAFLD、仅有NAPS以及两个器官均有脂肪变性的患者中，胰岛素抵抗的发生率分别为8.7%、26.7%、19%和61.3%。研究组中明显患有2级和3级脂肪变性的NAFLD和NAPS分别占15.3%和29.0%。胰腺回声正常、仅有NAFLD、仅有NAPS的患者中胆囊结石的发生率分别为6.8%、13.6%和28.8%（p=0.01）。
基于所纳入患者的超声、临床、人口统计学和人体测量学特征，我们发现NAPS并不完全与非酒精性脂肪肝同时存在。尽管胰腺脂肪变性严重，但超过四分之一的病例肝脏回声正常。NAFLD中胰岛素抵抗的发生率略高于NAPS，但差异无统计学意义（p=0.694）。NAPS中胆囊结石的发生率显著更高，这需要进一步的大规模研究。超过50%的病例中NAPS和NAFLD脂肪变性程度的不一致可能反映了这两种临床实体在病理生理学上的差异。
