Non-alcoholic Fatty Pancreatic Disease Research Articles

Метаболические аспекты жировой болезни поджелудочной железы

Aim. To update the understanding of non-alcoholic fatty pancreatic disease as an important component of the development and maintenance of metabolic syndrome, to present current data on the connection of this pathology with cardiovascular risks, and to outline approaches to diagnosis and treatment. Key points. Metabolic syndrome is one of the most common pathologies that significantly increases cardiovascular risks. It is known that excessive accumulation of lipids in the pancreas in patients with metabolic syndrome inevitably entails impaired functioning of beta cells. However, the term characterizing metabolic dysfunction of the pancreas against the background of its steatosis was introduced into circulation relatively recently. Thus, non-alcoholic fatty pancreatic disease acquires its own definitions that distinguish it from the traditional morphological approach, which consists more in assessing the content of the proportion of adipose tissue, but not the connection with the components of the metabolic syndrome. It is known that patients with non-alcoholic fatty pancreatic disease are more likely to have type 2 diabetes mellitus, arterial hypertension and atherosclerosis. Probably, the pathogenesis of its development is also closely related to non-alcoholic fatty liver disease. Conclusion. Non-alcoholic fatty pancreatic disease, being one of the key mechanisms of metabolic dysfunction, requires further research in order to determine preventive and therapeutic tactics. Keywords: insulin resistance, non-alcoholic fatty pancreatic disease, pancreatic steatosis, metabolic syndrome.

Evaluation of Development of Nonalcoholic Fatty Pancreas Disease After Post-Endoscopic Retrograde Cholangiop ancreatography Pancreatitis in Liver Transplant Patients: Computerized Tomography Versus Ultrasound.

Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is the most common serious adverse event in liver transplant patients The average incidence has been reported as 1.3%-15.1% in prospective series. In our study, we have prospectively evaluated the prevalence of nonalcoholic fatty pancreatic disease (NAFPD) after PEP via computerized tomography (CT) and determined the ratio of fatty pancreas by ultrasound imaging in liver transplant patients. We have retrospectively analyzed 2922 patient files, and 146 patients were indicated for ERCP. PEP was observed in 32 patients. After presenting the significant association between the NAFPD and PEP, we prospectively reached 32 patients included in the study. Ten out of those patients have been performed ultrasound with regard to NAFPD. PEP was defined in 32 patients in whom CT was performed to investigate NAFPD. When the patients were contacted, it was observed that 12% were deceased, 71% were alive, but 15% of them were untraceable. Ultrasound has been performed on 10 of 32 patients to determine NAFPD. There was a significant reduction in post-PEP pancreas/spleen rate compared to pre-PEP pancreas/ spleen rate (P = .001). Both the pre-PEP and post-PEP pancreas-spleen difference dropped significantly (P = .002). Ultrasound imaging could be utilized as a scanning test and an alternative to evaluate and diagnose NAFPD, particularly in risky patients.

Correlation between type 2 diabetes mellitus and pancreatic steatosis

Objective. To study the features of endocrine function in non-alcoholic fatty disease of the pancreas in patients with chronic pancreatitis in remission.
 Materials and methods. There were examined 62 patients with chronic pancreatitis without exacerbation, who were admitted to the day hospital department of the City Clinical Hospital № 9 (Izhevsk). The data of laboratory and instrumental research methods, the features of the pancreatic endocrine function in patients with chronic pancreatitis, accompanied by fatty degeneration of the organ were analyzed.
 Results. Pancreatic steatosis was detected in 80.8 % of cases in patients with chronic pancreatitis in remission with metabolically complicated obesity. Violation of endocrine function was diagnosed in 19.3 % of cases. In the presence of insulin resistance, 6 (16.7 %) of the examined patients were diagnosed type 2 diabetes for the first time. At high insulin levels, 4 (6.5 %) patients had no changes in the indicators of fasting sugar.
 Conclusions. All patients with increased insulin resistance and metabolically complicated obesity require a comprehensive clinical and laboratory-instrumental study for the early detection of non-alcoholic fatty pancreatic disease. When establishing the signs of fatty degeneration of the pancreas, dispensary observation as well as prophylactic and therapeutic measures are necessary to prevent the development of type 2 diabetes mellitus.

Frequency of Nonalcoholic fatty pancreatic disease in patients with carcinoma pancreas presenting for upper abdominal Endoscopic Ultrasound in a tertiary care center.

To determine the frequency of nonalcoholic fatty pancreatic disease in patients with carcinoma pancreas presenting for upper abdominal endoscopic ultrasound. The prospective cross-sectional study was conducted in the Endoscopy Suite of Surgical Unit 4, Civil Hospital, Karachi, from October 2019 to September 2020, and comprised patients presenting for endoscopic ultrasound. Patients were divided into Group A comprising carcinoma pancreas patients, and Group B having non-carcinoma pancreas patients. Fatty pancreas was identified by hyperechogenicity on endoscopic ultrasound. Data was analysed using SPSS 19. Of the 68 patients, 44(64.7%) were male and 24(35.3%) were females. The overall mean age was 49.9±13.82 years (range: 16-80 years). There were 35(51.5%) patients in Group A and 33(48.5%) in Group B. The frequency of nonalcoholic fatty pancreatic disease was 18(26.5%) and 15(83.3%) of them were male subjects (p=0.04). Group A had 12(34.28%) subjects with nonalcoholic fatty pancreatic disease compared to 6(18%) in Group B (p=0.11). Nonalcoholic fatty pancreatic disease was frequently seen in carcinoma pancreas patients undergoing endoscopic ultrasound compared to non-carcinoma pancreas patients. Most of the patients affected were males.

Pancreatic and hepatobiliary manifestations of nonalcoholic fatty pancreatic disease: a referral multi-center experience.

Nonalcoholic fatty pancreatic disease (NAFPD) is an increasingly recognized disease with accumulating evidence of associated co-morbidities. However, data linked with other pancreatic and hepatobiliary disorders are still being studied. To investigate the association of pancreato-hepato-biliary disorders with NAFPD. At two Israeli medical centers, a total of 569 patients were analyzed who underwent endoscopic ultrasound for hepatobiliary indications. They were divided into groups depending on the presence or absence of NAFPD. Seventy-eight patients (13.7%) had NAFPD (NAFPD group) vs. 491 patients (86.3%) without (non-NAFPD group). NAFPD was significantly associated with obesity [odds ratio (OR) 4.98, 95% confidence interval (CI) 3.02-8.24, P < 0.0001], hypertension (OR 2.55, 95% CI 1.57-4.15, P = 0.0002), active smoking (OR 2.02, 95% CI 1.04-3.93, P = 0.03), and hyperlipidemia (OR 2.86, 95% CI 1.58-5.18, P = 0.0005). On multivariate regression analysis: fatty liver (OR 5.49, 95% CI 2.88-10.49, P < 0.0001), main duct intraductal papillary mucinous neoplasm (M-IPMN) (OR 2.69, 95% CI 1.05-6.9, P = 0.04), and gallstones (OR 1.93, 95% CI 1.1-3.38, P = 0.02) were the most endoscopically and ultrasonographically detected diseases that significantly correlated with NAFPD. NAFPD was associated with several diseases, most importantly the premalignant M-IPMN. Further investigation for these coexisting diseases should be considered.

Epidemiological studies on the prevention and treatment of nonalcoholic fatty pancreatic disease

Epidemiological studies on the prevention and treatment of nonalcoholic fatty pancreatic disease

Bile acids, non-alcoholic fatty liver and pancreatic disease: chained by ursodeoxycholic acid?

Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic fatty pancreatic disease (NAFPD) develop against the background of metabolic syndrome, systemic insulin resistance, oxidative stress, changes in lipid and carbohydrate metabolism. There are a number of similarities between NAFLD and NAFPD: the natural course of diseases proceeds from steatosis through inflammation to fibrosis and cancer, one of the etiopathogenetic factors is the disbalance of bile acids synthesis and low expression of farnesoid receptor X (FXR). One of the possible methods of treatment NAFLD and NAFPD is a correction of the biosynthesis of bile acids and increase FXR expression with FXR agonists. Ursodeoxycholic acid (UDCA) is a selective FXR agonist. It has a multipled spectrum of actions: anticholestatic, anti-apoptic, antioxidant, cytoprotective, antifibrotic, hypocholesterolemic, immunomodulatory, hepatoprotective. The ability of UDCA correct lipid and carbohydrate metabolism in combination with anti-inflammatory and antiapoptic effects may be of great importance for the treatment of NAFLD and NAFPD. The article reviews the results of clinical and experimental studies describing the efficacy of UDCA in NAFLD and some pancreatic diseases. It has been suggested that the therapy of UDCA can reduce the severity of NAFLD and NAFPDand improve the functional activity of hepatocytes and β cells. The need for randomized clinical trials was emphasized in order to make an informed decision on the expediency of including UDCA in the treatment of NAFLD and NAFPD.

Dyslipidemia and cardiovascular complications in patients with non-alcoholic fatty pancreatic disease

Background and Aims: To assess the incidence of dyslipidemia and cardiovascular complications in patients with non-alcoholic fatty pancreatic disease (NAFPD).

Parallels between non-alcoholic fatty liver disease and non-alcoholic fatty pancreatic disease: looking for points of contact or regard through the lens of metabolic syndrome

The aim. The aim of our study was to analyze the available data from literature sources concerning the issues of etiology, pathogenesis, clinic, diagnosis and features of treatment of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic fatty pancreatic disease (NAFPD).Materials and methods. We conducted a retrospective analysis of foreign literature sources that contain up-to-date information about the state of the problem of NAFLD and NAFPD.Results. NAFLD and NAFPD develop against the background of metabolic syndrome (MS), systemic insulin resistance, oxidative stress, changes in lipid metabolism. The natural course of NAFPD is associated with high risk of MS progression, occurrence of NAFLD, arterial hypertension, type 2 diabetes mellitus, exocrine pancreatic insufficiency, acute and chronic pancreatitis, pancreas cancer. Correction of the components of MS can reduce the severity of NAFLD and NAFPD; enzyme replacement therapy can improve the function of β-cells in pancreas steatosis.Conclusion. The alternatives of the pharmacological treatment of NAFLD and NAFPD continue to be actively explored. We emphasize the need of including medications containing pancreatic enzymes in the treatment of NAFLD.

Research status and prgoress of nonalcoholic fatty pancreatic disease

Research status and prgoress of nonalcoholic fatty pancreatic disease

PANCREATIC STEATOSIS: A NEW DIAGNOSIS AND THERAPEUTIC CHALLENGE IN GASTROENTEROLOGY.

Fat infiltration in the pancreas is called pancreatic steatosis and it has several synonyms such as pancreatic lipomatosis, non-alcoholic fatty pancreatic disease, lipomatous pseudohypertrophy, fatty replacement, fatty pancreas and fatty infiltration. Pancreatic steatosis describes a disease ranging from infiltration of fat in the pancreas to pancreatic inflammation, and development of pancreatic fibrosis. There are multiple aetiologies of this condition, such as metabolic syndrome, alcohol intake, viral infections, toxins, congenital syndromes, etc. Pancreatic steatosis is usually diagnosed by trans-abdominal ultrasound, computed tomography scan and magnetic resonance imaging. Fatty infiltration in pancreas may lead to pancreatitis, diabetes mellitus and may be a predisposing cause of pancreatic cancer. Now a day, pancreatic steatosis is a common incidental finding during abdominal ultrasonography for other reasons and is a new challenge in Gastroenterology. But there is no guideline for pancreatic steatosis till now. In this review article, we are trying to give an overall idea (aetiologies, diagnosis, management, clinical significances) on pancreatic steatosis.

Epigenetic modification in nonalcoholic fatty pancreatic disease and pancreatic cancer

Epigenetic modification in nonalcoholic fatty pancreatic disease and pancreatic cancer

Research progress on nonalcoholic fatty pancreatic disease pathogenesis

Research progress on nonalcoholic fatty pancreatic disease pathogenesis

Diagnosing pancreatic steatosis in obese patients

Frequency of pancreatic steatosis in adults of general population is up to 35%. Causes of triglyceride accumulation in the pancreas include aging, obesity, type 2 diabetes mellitus, metabolic syndrome, hypertriglyceridemia (genetically determined or secondary one). Nomenclature by M. M. Smits is used for diagnosing, which sets out pancreatic steatosis, lipomatous pseudohypertrophy of the pancreas, fatty replacement of the pancreas, fatty infiltration of the pancreas, non-alcoholic fatty pancreatic disease, non-alcoholic pancreatic steatosis, non-alcoholic steatopancreatitis.&#x0D; Pancreatic steatosis usually does not have any clinical manifestations, as it is characterized by an asymptomatic course. It is diagnosed on the basis of results of imaging methods (ultrasound, computed or magnetic resonance imaging). According to the ultrasound, there are 3 degrees of pancreatic steatosis:&#x0D; &#x0D; Degree I — pancreatic echogenicity is equal to the echogenicity of adipose tissue in area of superior mesenteric artery. Pancreas is not enlarged, echogenicity is uniformly increased, contour is smooth, splenic vein, superior mesenteric artery and pancreatic duct are well-visualized;&#x0D; Degree II — increased echogenicity on the background of weak signal in the remote, dorsal part of the pancreas (reduced acoustic signal conductivity, attenuation of the ultrasonic signal behind the posterior surface of the pancreas), indistinct edges of splenic vein and pancreatic duct with almost non-visualized area of superior mesenteric artery;&#x0D; Degree III — reduction of ultrasound conductivity of the pancreas, undulating (convoluted), indistinct contours, splenic vein, area of superior mesenteric artery and pancreatic duct are not visualized.&#x0D; &#x0D; Main feature of the pancreas lesion in obesity is the absence of changes in biochemical indices or their minor changes. Exocrine and endocrine pancreatic insufficiency, hyperlipidemia may develop.

Lipid Profiles And Non-Alcoholic Fatty Pancreatic Disease In Obese Adult

Lipid Profiles And Non-Alcoholic Fatty Pancreatic Disease In Obese Adult

Metabolic and Histopathological Changes Correlating with High-Fat Diet-Induced Non-Alcoholic Fatty Pancreatic Disease in Mice : The Role of Cotreatment with Olive Oil

Metabolic and Histopathological Changes Correlating with High-Fat Diet-Induced Non-Alcoholic Fatty Pancreatic Disease in Mice : The Role of Cotreatment with Olive Oil

A noteworthy disease: non-alcoholic fatty pancreatic disease

A noteworthy disease: non-alcoholic fatty pancreatic disease

Prevalence of Non-Alcoholic Fatty Pancreas Disease (NAFPD) and its risk factors among adult medical check-up patients in a private hospital: a large cross sectional study.

BackgroundThe clinical significance of non-alcoholic fatty pancreatic disease (NAFPD) or fatty pancreas is largely unknown. It is often an incidental finding on abdominal ultrasound, which is not explored further, especially its association with metabolic condition and the risk of pancreatic malignancy. The aim of this study is to evaluate the presence of NAFPD and its associated risk factors among adult medical check-up patients.MethodA large cross-sectional study was done among adult medical check-up patients underwent abdominal ultrasound between January and December 2013 in Medistra Hospital, Jakarta. Data was obtained from the patients’ medical record and include demographic data, blood pressures, fasting blood glucose level, and lipid profile. The presence of fatty pancreas was diagnosed by ultrasound. Bivariate and multivariate analyses were done to find associated risk factors for NAFPD. Statistical analysis was done using SPSS version 17.ResultsA total of 1054 cases were included in this study; pancreas cannot be visualized in 153 cases and were excluded from the analysis. Fatty pancreas was present in 315 (35.0 %) patients. Bivariate analyses found associations among fatty pancreas and several risk factors such as gender, age, systolic and diastolic blood pressures, body mass index (BMI), fasting plasma glucose (FPG), triglycerides (TG) and cholesterol levels.ConclusionFatty pancreas is a common finding during medical check-up with a prevalence of 35 %. Fatty pancreas has significant association with metabolic factors and it might have an important role in risk of malignancy.

Nonalcoholic fatty pancreatic disease and cardio-metabolic risk: is there is a place for obstructive sleep apnea?

BackgroundObstructive sleep apnea is a common disorder acting as a risk factor for the development and progression of cardiometabolic derangements including non-alcoholic fatty liver disease. Recent research data suggest that non-alcoholic fatty pancreatic disease may be a more sensitive marker than non-alcoholic fatty liver disease for early subclinical metabolic risk and may contribute to the progression of subclinical disease to overt type 2 diabetes mellitus.Presentation of the hypothesisWe postulate that obstructive sleep apnea may be a risk factor for non-alcoholic fatty pancreatic disease. It is well known that intermittent hypoxia related to obstructive sleep apnea leads to hormonal derangements. Excessive lipolysis, enhanced lipid synthesis and systemic and local inflammation may favor ectopic fat deposition similarly to non-alcoholic fatty liver disease. Furthermore, it is possible that obstructive sleep apnea can lead to pancreatic beta cell damage via intermittent hypoxia.Testing of the hypothesisFuture research should focus on the following: first, whether non-alcoholic fatty pancreatic disease is an independent risk factor for the development of metabolic disease including diabetes mellitus or is a simple consequence of obesity; second, the prevalence of non-alcoholic fatty pancreatic disease among people with obstructive sleep apnea and vice versa, which should be compared to the prevalence of these diseases in general population; third, whether coexistence of these conditions is related to greater cardiometabolic risk than either disease alone; and fourth, whether the treatment of obstructive sleep apnea will translate into the resolution of non-alcoholic fatty pancreatic disease.Implications of the hypothesisIf proven, this hypothesis will provide new knowledge on the complex interplay between various metabolic insults. Second, screening for NAFPD may identify individuals at risk for developing type 2 diabetes mellitus for targeted prevention. Third, screening for the presence of non-alcoholic fatty pancreatic disease in patients with obstructive sleep apnea may help to decrease the incidence of diabetes mellitus through a targeted prevention.

Pancreatic steatosis: Is it related to either obesity or diabetes mellitus?

The accumulation of fat in the pancreatic gland has been referred to using various synonyms, such as pancreatic lipomatosis, fatty replacement, fatty infiltration, fatty pancreas, lipomatous pseudohypertrophy, non-alcoholic fatty pancreatic disease and pancreatic steatosis We believe that pancreatic steatosis is the best description of fat accumulation in the pancreatic gland without fat replacement, and this term also describes the possibility that the fat accumulation is a reversible process. A review of the existing literature was carried out, and it was found that there was notable evidence from both the pathological and the imaging point of view that pancreatic steatosis is an increasing problem due to the increasing incidence of obesity. The conclusion was that pancreatic steatosis was easily detectable using modern imaging techniques, such as ultrasonography, endoscopic ultrasonography, computed tomography and magnetic resonance imaging. Pancreatic steatosis was not due to the presence of diabetes mellitus but was highly associated with the metabolic syndrome. The possible presence of steatopancreatitis should be better evaluated, especially regarding the inflammatory cascade, and additional studies are needed which are capable of assessing whether non-alcoholic steatopancreatitis really exists as does non-alcoholic steatohepatitis. Finally, the presence of exocrine pancreatic function should be extensively evaluated in patients with pancreatic steatosis.