A prospective evaluation of fatty pancreas by using EUS

BackgroundFatty liver is associated with obesity, diabetes, hyperlipidemia, and the metabolic syndrome. The pathophysiology of fatty pancreas is poorly understood, but it may be closely related to fatty liver.ObjectiveThe aim of our study was to determine the prevalence of fatty pancreas and risk factors associated with its development.DesignProspective, single center study.SettingTertiary-care academic medical center.PatientsThis study involved 250 consecutive patients referred for EUS examination.InterventionAll patients undergoing EUS at our institution were prospectively identified. Information regarding demographics, tobacco use, alcohol use, blood test results, and comorbidities were collected before EUS. Pancreatic echogenicity was graded in comparison to the spleen at the time of EUS by using an a priori specified grading scheme.Main Outcome MeasurementsPrevalence of fatty pancreas and factors associated with its development.ResultsDuring the study period, 250 consecutive patients were prospectively enrolled. The prevalence of fatty pancreas was 27.8% (95% CI, 22.1-34.1). Fatty liver was seen in 22.6% of patients. Factors associated with fatty pancreas on univariate analysis were increasing body mass index (BMI) (P = .004), fatty liver (P < .0001), hyperlipidemia (P = .04), and the metabolic syndrome (odds ratio [OR] 3.13, P = .004). The presence of any metabolic syndrome components, that is, BMI ≥30, hyperlipidemia, diabetes, or hypertension, increased the prevalence of fatty pancreas by 37% (OR 1.37, P = .01). Factors independently associated with fatty pancreas on multivariate analysis were increasing BMI (OR 1.05, P = .03) and fatty liver (OR 3.61, P < .001). We found no association between fatty pancreas and chronic pancreatitis or adenocarcinoma of the pancreas.LimitationsSingle institution study. All patients were referred for EUS, which limits generalizability. Lack of histological confirmation of pancreatic fat.ConclusionWe found a strong association between fatty pancreas and the metabolic syndrome.