title: Association between novel MRI-estimated pancreatic fat and liver histology-determined steatosis and fibrosis in non-alcoholic fatty liver disease.
abstract: BACKGROUND
  Ectopic fat deposition in the pancreas and its association with hepatic steatosis have not previously been examined in patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD).
  
  
  OBJECTIVE
  To quantify pancreatic fat using a novel magnetic resonance imaging (MRI) technique and determine whether it is associated with hepatic steatosis and/or fibrosis in patients with NAFLD.
  
  
  METHODS
  This is a cross-sectional study including 43 adult patients with biopsy-proven NAFLD who underwent clinical evaluation, biochemical testing and MRI. The liver biopsy assessment was performed using the NASH-CRN histological scoring system, and liver and pancreas fat quantification was performed using a novel, validated MRI biomarker; the proton density fat fraction.
  
  
  RESULTS
  The average MRI-determined pancreatic fat in patients with NAFLD was 8.5% and did not vary significantly between head, body, and tail of the pancreas. MRI-determined pancreatic fat content increased significantly with increasing histology-determined hepatic steatosis grade; 4.6% in grade 1; 7.7% in grade 2; 13.0% in grade 3 (P = 0.004) respectively. Pancreatic fat content was lower in patients with histology-determined liver fibrosis than in those without fibrosis (11.2% in stage 0 fibrosis vs. 5.8% in stage 1-2 fibrosis, and 6.9% in stage 3-4 fibrosis, P = 0.013). Pancreatic fat did not correlate with age, body mass index or diabetes status.
  
  
  CONCLUSIONS
  In patients with NAFLD, increased pancreatic fat is associated with hepatic steatosis. However, liver fibrosis is inversely associated with pancreatic fat content. Further studies are needed to determine underlying mechanisms to understand if pancreatic steatosis affects progression of NAFLD.
authors: Division of Internal Medicine, Department of Medicine, University of California, San Diego, CA, USA.
authors: N S
authors: NS
authors: Patel
authors: M R
authors: MR
authors: Peterson
authors: D A
authors: DA
authors: Brenner
authors: E
authors: E
authors: Heba
authors: C
authors: C
authors: Sirlin
authors: R
authors: R
authors: Loomba
mesh_terms: D050154:Adiposity; D000328:Adult; D001706:Biopsy; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005234:Fatty Liver / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D010179:Pancreas / Q000473:pathology*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index
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