title: A prospective evaluation of fatty pancreas by using EUS.
abstract: BACKGROUND
  Fatty 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.
  
  
  OBJECTIVE
  The aim of our study was to determine the prevalence of fatty pancreas and risk factors associated with its development.
  
  
  METHODS
  Prospective, single center study.
  
  
  METHODS
  Tertiary-care academic medical center.
  
  
  METHODS
  This study involved 250 consecutive patients referred for EUS examination.
  
  
  METHODS
  All 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.
  
  
  METHODS
  Prevalence of fatty pancreas and factors associated with its development.
  
  
  RESULTS
  During 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.
  
  
  CONCLUSIONS
  Single institution study. All patients were referred for EUS, which limits generalizability. Lack of histological confirmation of pancreatic fat.
  
  
  CONCLUSIONS
  We found a strong association between fatty pancreas and the metabolic syndrome.
authors.affiliation: Division of Gastroenterology, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Sepe
authors.forename: Ashray
authors.initials: A
authors.lastname: Ohri
authors.forename: Sirish
authors.initials: S
authors.lastname: Sanaka
authors.forename: Tyler M
authors.initials: TM
authors.lastname: Berzin
authors.forename: Sandeep
authors.initials: S
authors.lastname: Sekhon
authors.forename: Gayle
authors.initials: G
authors.lastname: Bennett
authors.forename: Gaurav
authors.initials: G
authors.lastname: Mehta
authors.forename: Ram
authors.initials: R
authors.lastname: Chuttani
authors.forename: Robert
authors.initials: R
authors.lastname: Kane
authors.forename: Douglas
authors.initials: D
authors.lastname: Pleskow
authors.forename: Mandeep S
authors.initials: MS
authors.lastname: Sawhney
mesh_terms: D015992:Body Mass Index; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods*; D005234:Fatty Liver / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging*; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors