Becetti Imen, Lopez Lopez Ana Paola, Galbiati Francesca, Pedreira Clarissa C, Lauze Meghan, Carreno Karen Olivar, Huber Florian A, Bitoun Olivier, Lee Hang, Carmine Brian, Singhal Vibha, Misra Madhusmita, Bredella Miriam A
Division of Pediatric Endocrinology, Mass General Hospital for Children and Harvard Medical School, Boston, Massachusetts; Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Surg Obes Relat Dis. 2025 Jan;21(1):59-66. doi: 10.1016/j.soard.2024.08.034. Epub 2024 Sep 10.
Pancreatic steatosis has been associated with obesity and the metabolic syndrome. Studies in adults have demonstrated improvement in pancreatic steatosis following sleeve gastrectomy (SG) with concomitant improvement in glucose homeostasis.
To examine changes in pancreatic steatosis in youth with severe obesity 24 months following SG.
Academic hospital system.
Forty-seven youth (13-24 years) with severe obesity (37 females) were followed for 24 months; 23 had SG and 24 were nonsurgical (NS) controls. Attenuations of the pancreas and spleen were measured using computed tomography (CT) at baseline, 12- and 24-month follow-up. Subjects underwent magnetic resonance imaging (MRI) for subcutaneous and visceral adipose tissue (SAT, VAT), dual energy x-ray absorptiometry (DXA) for body composition, blood sampling for glycated hemoglobin (A1C), and fasting and postprandial insulin and glucose. Linear mixed effects (LMEs) models were used to compare within- and between-group changes over 24 months.
At baseline, SG had higher body mass index (BMI) versus NS (P = .033). Over 24 months, significant reductions were noted in weight, BMI, VAT, SAT, fat mass (FM), and lean mass (LM) in the SG versus NS groups (P ≤ .0001). There was a significant 24-month decrease in pancreatic steatosis in the SG group (P = .006). In the whole group, 24-month reductions in pancreatic steatosis correlated with BMI and FM decreases. No associations were found between pancreatic steatosis and glucose homeostasis parameters.
Pancreatic steatosis measured by CT improved after SG in youth. Further studies are needed to understand the relationship between pancreatic steatosis and glucose homeostasis.
胰腺脂肪变性与肥胖及代谢综合征相关。成人研究表明，袖状胃切除术（SG）后胰腺脂肪变性有所改善，同时血糖稳态也得到改善。
研究严重肥胖青少年在SG术后24个月时胰腺脂肪变性的变化。
学术医院系统。
47名严重肥胖的青少年（13 - 24岁，37名女性）接受了24个月的随访；23例行SG手术，24名为非手术（NS）对照组。在基线、12个月和24个月随访时，使用计算机断层扫描（CT）测量胰腺和脾脏的衰减值。受试者接受磁共振成像（MRI）测量皮下和内脏脂肪组织（SAT、VAT），采用双能X线吸收法（DXA）测量身体成分，采集血样检测糖化血红蛋白（A1C）以及空腹和餐后胰岛素及血糖。使用线性混合效应（LMEs）模型比较24个月内组内和组间的变化。
基线时，SG组的体重指数（BMI）高于NS组（P = 0.033）。在24个月期间，SG组的体重、BMI、VAT、SAT、脂肪量（FM）和瘦体重（LM）较NS组显著降低（P≤0.0001）。SG组胰腺脂肪变性在24个月时显著降低（P = 0.006）。在整个研究组中，胰腺脂肪变性在24个月时的降低与BMI和FM的降低相关。未发现胰腺脂肪变性与血糖稳态参数之间存在关联。
青少年在SG术后，通过CT测量的胰腺脂肪变性有所改善。需要进一步研究以了解胰腺脂肪变性与血糖稳态之间的关系。
