School of Medicine, University of Auckland, Auckland, New Zealand.
Am J Gastroenterol. 2022 Oct 1;117(10):1693-1701. doi: 10.14309/ajg.0000000000001951. Epub 2022 Aug 12.
Increased intrapancreatic fat deposition (IPFD) has emerged as a harbinger of pancreatic cancer and chronic pancreatitis. Although it is well recognized that diseases of the exocrine pancreas often lie on a continuum (with acute pancreatitis preceding the development of chronic pancreatitis and/or pancreatic cancer), whether increased IPFD predisposes to acute pancreatitis is unknown. This study aimed to compare fat depositions in the pancreas (as well as the liver and skeletal muscle) between individuals who developed first attack of acute pancreatitis and healthy individuals.
This was a matched case-control study nested into population-based cohort. MRI on a single 3 T scanner was used to quantify intrapancreatic, liver, and skeletal muscle fat depositions using the same protocols in all study participants. Binary logistic regression with adjustment for body mass index and other possible confounders was performed.
Fifty individuals with first attack of nonnecrotizing acute pancreatitis comprised the case group and 100 healthy individuals comprised the control group. A 1% increase in IPFD (but not the other fat depositions) was significantly associated with a more than 30% higher chance of developing first attack of acute pancreatitis, consistently in both the unadjusted ( P = 0.004) and all adjusted models. Furthermore, a 1% increase in IPFD (but not the other fat depositions) was significantly associated with up to a 27% higher chance of developing first attack of acute pancreatitis in individuals with normotriglyceridemia, consistently in both the unadjusted ( P = 0.030) and all adjusted models.
Increased IPFD may predispose to the development of acute pancreatitis. This opens up opportunities for reducing the burden of acute pancreatitis by means of primary prevention.
胰内脂肪沉积（IPFD）的增加已成为胰腺癌和慢性胰腺炎的先兆。虽然人们普遍认识到外分泌胰腺疾病通常存在于一个连续体中（急性胰腺炎先于慢性胰腺炎和/或胰腺癌的发展），但增加的 IPFD 是否易患急性胰腺炎尚不清楚。本研究旨在比较首次发作急性胰腺炎患者与健康个体之间胰腺（以及肝脏和骨骼肌）中的脂肪沉积。
这是一项嵌套在基于人群的队列中的匹配病例对照研究。在所有研究参与者中，使用相同的方案，通过单一 3T 扫描仪的 MRI 定量测量胰内、肝和骨骼肌脂肪沉积。采用二元逻辑回归，调整体重指数和其他可能的混杂因素。
50 名首次发作非坏死性急性胰腺炎的患者组成病例组，100 名健康个体组成对照组。IPFD 增加 1%（但不是其他脂肪沉积）与首次发作急性胰腺炎的几率增加 30%以上显著相关，在未调整（P=0.004）和所有调整模型中均一致。此外，IPFD 增加 1%（但不是其他脂肪沉积）与非高甘油三酯血症患者首次发作急性胰腺炎的几率增加 27%显著相关，在未调整（P=0.030）和所有调整模型中均一致。
增加的 IPFD 可能易患急性胰腺炎。这为通过初级预防来降低急性胰腺炎的负担提供了机会。
