The effect of fatty pancreas on serum glucose parameters in patients with nonalcoholic steatohepatitis

• Fat accumulation in pancreas may have some metabolic effects on glucose metabolism.
• Fatty pancreas and its implications on glucose metabolism were studied in NASH.
• Half of the patients with NASH had fatty pancreas in sonographic examination.
• Prediabetes/diabetes was more frequent in patients with NASH and fatty pancreas.

ObjectiveFatty pancreas (FP) is related to obesity, and may have some clinical implications on glucose metabolism. The frequency and importance of FP in patients with nonalcoholic steatohepatitis (NASH) are not clear. This study aimed to investigate: the frequency of FP in patients with NASH, and its effects on serum glucose parameters.MethodsFP was detected and graded by transabdominal ultrasonography (USG) in patients with biopsy-proven NASH and healthy controls. Body Mass Index and waist circumference were recorded, and serum lipids, fasting serum glucose, HbA1c, OGTT 2-h, insulin level, insulin resistance, type 2 diabetes mellitus (DM) and prediabetes rates were detected.ResultsEighty-four subjects with NASH and 35 healthy controls were enrolled in the study. There was no FP in 41 (48.8%) of the NASH patients according to the study criteria. Forty-three of the NASH patients and 5 of the controls had different grades of fat in their pancreas (51.2% vs. 14%, p = 0.001). The HbA1c and OGTT 2-h results were significantly higher in NASH patients with FP compared to those without FP (p = 0.003 and p = 0.018). The rates of both prediabetes and DM were also found to be significantly increased in NASH patients with FP (p = 0.004). The mean waist circumference was higher in patients with FP (p = 0.027). Grade of FP by USG showed no effect on study parameters in subgroup analysis.ConclusionFP is common in patients with NASH and increases the rate of prediabetes and DM. The coexistence of both NASH and FP has a further impact on glucose metabolism and DM frequency.