Fatty pancreas, insulin resistance, and β-cell function: a population study using fat-water magnetic resonance imaging.
OBJECTIVE
Nonalcoholic fatty liver disease is the most common chronic liver disease. Fatty pancreas has also been described but is difficult to assess. It is now possible to measure pancreatic and liver fat accurately with magnetic resonance imaging (MRI). We aimed to define the normal range of pancreatic fat and identify factors associated with fatty pancreas. In addition, the effect of fatty liver and fatty pancreas on insulin resistance (IR) and pancreatic β-cell function was studied.


METHODS
Fat-water MRI and proton-magnetic resonance spectroscopy were performed on 685 healthy volunteers from the general population to measure pancreatic and liver fat, respectively. On the basis of fasting plasma glucose and insulin levels, the IR and β-cell function were assessed using the homeostasis model assessment (HOMA).


RESULTS
Among subjects without significant alcohol consumption or any component of metabolic syndrome, 90% had pancreatic fat between 1.8 and 10.4%. Using the upper limit of normal of 10.4%, 110 (16.1%; 95% confidence interval 13.3-18.8%) subjects had fatty pancreas. On multivariable analysis, high serum ferritin, central obesity, and hypertriglyceridemia were independent factors associated with fatty pancreas. Subjects with both fatty pancreas and fatty liver had higher HOMA-IR than did those with either condition alone. Fatty pancreas was not associated with HOMA-β after adjusting for liver fat and body mass index.


CONCLUSIONS
In all, 16.1% of this community cohort of adult Hong Kong Chinese volunteers had a fatty pancreas by our definition. Central obesity, hypertriglyceridemia, and hyperferritinemia are associated with fatty pancreas. Individuals with fatty pancreas have increased IR.
1] Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China [2] Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Vincent Wai-Sun
VW
Wong
1] Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China [2] Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Grace Lai-Hung
GL
Wong
Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, China.
David Ka-Wai
DK
Yeung
Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China.
Jill M
JM
Abrigo
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Alice Pik-Shan
AP
Kong
1] Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China [2] Centre for Nutritional Studies, The Chinese University of Hong Kong, Hong Kong, China.
Ruth Suk-Mei
RS
Chan
1] Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China [2] Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Angel Mei-Ling
AM
Chim
1] Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China [2] Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Jiayun
J
Shen
Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong, China.
Chung-Shun
CS
Ho
1] Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China [2] Centre for Nutritional Studies, The Chinese University of Hong Kong, Hong Kong, China.
Jean
J
Woo
1] Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China [2] Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China.
Winnie Chiu-Wing
WC
Chu
1] Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China [2] Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Henry Lik-Yuen
HL
Chan
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005234:Fatty Liver / Q000150:complications* / Q000473:pathology; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000502:physiology*; D050152:Intra-Abdominal Fat / Q000033:anatomy & histology / Q000473:pathology*; D016014:Linear Models; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease; D010179:Pancreas / Q000033:anatomy & histology / Q000473:pathology*; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D015995:Prevalence; D012016:Reference Values; D012307:Risk Factors