title: Lack of Independent Association Between Fatty Pancreas and Incidence of Type 2 Diabetes: 5-Year Japanese Cohort Study.
abstract: Previous cross-sectional studies have shown that attenuation in the pancreas seen on unenhanced computed tomography (CT) scans was inversely correlated with histologic pancreatic fat, and that fatty pancreas was associated with type 2 diabetes mellitus (T2DM). However, no longitudinal study has evaluated whether fatty pancreas increases the incidence of T2DM. We conducted a cohort study to investigate the association between fatty pancreas and the incidence of T2DM.
  
  
  
  A total of 813 participants without diabetes underwent health checks by unenhanced CT scanning in 2008 and 2009, and were observed for a median follow-up period of 5.06 (interquartile range 3.01-5.92) years. Attenuation in three regions of the pancreas seen on an unenhanced CT scan was measured, and the mean pancreatic attenuation was calculated to evaluate fatty pancreas at baseline; the more severe the fatty pancreas, the lower the mean pancreatic attenuation. The incident T2DM hazard ratios (HRs) for the association between fatty pancreas and T2DM incidence were estimated by Cox proportional hazards models adjusted for age, sex, BMI, liver attenuation seen on unenhanced CT scan, and alcohol intake of ≥20 g/day.
  
  
  
  T2DM occurred in 62 participants (7.6%) during the follow-up period. The higher pancreas attenuation (i.e., less pancreatic fat) at baseline was associated with decreased T2DM incidence in a univariate analysis (crude HR 0.97 [95% CI 0.96-0.99]); and fatty pancreas (lower pancreas attenuation) was positively associated with increased T2DM incidence. However, the association was substantially explained by the confounders (multivariate HR 1.00 [95% CI 0.98-1.02]).
  
  
  
  Fatty pancreas was not independently associated with future T2DM.
authors.affiliation: Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan yamazaki-myz@umin.ac.jp.
authors.forename: Hajime
authors.identifier: 0000-0002-9034-4370
authors.initials: H
authors.lastname: Yamazaki
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Tsuboya
authors.affiliation: Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Katanuma
authors.affiliation: Department of Radiology, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kodama
authors.affiliation: Department of Radiology, Keijinkai Maruyama Clinic, Sapporo, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Tauchi
authors.affiliation: Department of Health Checkup and Promotion, Keijinkai Maruyama Clinic, Sapporo, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Dohke
authors.affiliation: Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Maguchi
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000473:pathology; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010182:Pancreatic Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed