Non-alcoholic Fatty Pancreatic Disease Research Articles

Extended Review and Updates of Nonalcoholic Fatty Pancreas Disease.

Non-alcoholic fatty pancreatic disease (NAFPD), also known as pancreatic steatosis, is a benign condition characterized by deposition of lipids in the pancreas and is associated with insulin resistance, malnutrition, obesity, metabolic syndrome, aging, and absence of heavy alcohol intake or infection. Similar to nonalcoholic fatty liver disease, NAFPD is a phenotypic entity that includes fat buildup in the pancreas, pancreatic inflammation, and subsequent fibrosis. The extent to which pancreatic fat infiltration is clinically important remains unclear. Despite these clinical associations, most of the clinical effects of NAFPD are not known. NAFPD may be identified by transabdominal and elastography ultrasound, computed tomography scan, or magnetic resonance imaging modalities, but a confirmatory diagnosis can only be made through tissue histology. In addition to complications such as acute and chronic pancreatitis, NAFPD may progress to pancreatic ductal adenocarcinoma. However, further research is required to fully understand the associations, pathophysiology, and effects of NAFPD. This review provides a narrative synthesis of the current literature on the epidemiology, pathophysiology, complications, diagnostic and imaging tools, and management of NAFPD.

Obstructive sleep apnoea is independently associated with non-alcoholic fatty pancreatic disease

Purpose This study investigated the prevalence of non-alcoholic fatty pancreatic disease (NAFPD) in patients with obstructive sleep apnoea (OSA) and analysed the correlation between them. Materials and methods Patients who underwent polysomnography and modified abdominal ultrasound examinations were continuously enrolled and divided into OSA and control groups. The OSA group was further divided into NAFPD and non-NAFPD groups. Differences in various indicators were compared. Binary logistic regression analyses were conducted to identify factors influencing NAFPD. Results A total of 210 participants were included in the study, including 178 in the OSA group and 32 in the control group. The prevalence of NAFPD, weight, body mass index (BMI), and other indicators were significantly higher in the OSA group than that in the control group (p < 0.05). The above indices, prevalence of hypertension and metabolic associated steatotic liver disease (MASLD), and severity of sleep apnoea were higher in the NAFPD group than that in the non-NAFPD group (p < 0.05). Binary logistic regression analysis showed a 4.4% increased risk of NAFPD for each unit increase in apnea-hypopnea index (AHI) after adjusting for BMI and hypertension. Conclusion The prevalence of NAFPD was higher in the OSA group than that in the control group, and chronic intermittent hypoxia was strongly associated with pancreatic fat infiltration; AHI, BMI, and hypertension were independent risk factors for NAFPD. The NAFPD group had a higher prevalence of obesity and some other diseases.

Role of Lipocalin-2 Levels in Non-Alcoholic Fatty Pancreatic Disease and its Association with Non-Alcoholic Fatty Liver Disease

Abstract Background Lipocalin-2 (LCN2) is a 25-kDa secretory protein with great importance as a sensitive and specific screening and diagnostic biomarker for hepatic inflammation, acute hepatic injury, hepatic cancer, and radiation-induced early phase hepatic damage and lipid abnormalities. However, little is known about LCN2's functions in the homeostasis and metabolism of hepatic lipids or in the development of steatosis as well as its actual role in the event of inflammation. Aim and Objectives To establish a correlation between the levels of lipocalin as a useful biomarker with increasing severity of steatosis in NAFLD and NAFPD patients. Subjects and Methods This was observational prospective case–control study, was conducted at Hepatology Unit of Ain Shams University Hospital on 50 patients diagnosed with NAFPD and 50 healthy age and sex-matched volunteers without NAFPD during a period of 6 months. All patients were subjected to; Full history taking and thorough clinical examination, Anthropometric measurements, Laboratory investigations, and abdominal ultrasonography. Result There was a significant Positive correlation between Lipocalin 2, BMI, LDL (mg/dL), Cholesterol (mg/dL), Insulin (μU/mL) and HOMA-IR in patient group(P-value ≤ 0.001), Conclusion; lipocalin-2 is a good blood biomarker for detection of hepatic and Pancreatic steatosis. The lipocalin levels increase with increasing severity of steatosis. In addition to this, lipocalin will be useful for early diagnosis of NAFLD, NAFPD and convenient to do with other blood tests. The early intervention may prevent high morbidity and mortality and to manage the disease properly.

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.&#x0D; 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.&#x0D; 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.&#x0D; 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