Table 1 Summary of human studies investigating pancreatic fat deposition

Al-Haddad et al. 2009 [44].

USA

Case control study using endoscopic ultrasound.

120 subjects (60 females). 60 subjects were found to have evidence of fatty pancreas.

Patients with fatty pancreas had greater BMI (mean BMI 31.7 kg/m² vs. BMI 25.4 of people without fatty pancreas), higher prevalence of fatty liver (57% vs 5%) and excessive alcohol use.

Lee et al. 2009 [22].

South Korea

Case control study using trans abdominal ultrasound and computed tomography.

293 subjects from obesity clinic (166 females). Patients with diabetes mellitus, thyroid disease, liver disease, pancreatic disease, renal disease and individuals with excessive alcohol use were excluded from the study.

180 subjects were found to have NAFPD. Male gender, greater BMI, waist circumference, visceral fat, alanine aminotransferase levels, triglyceride levels, fasting insulin levels and insulin resistance were strongly associated with NAFPD.

Choi et al. 2010 [45].

South Korea

Case control study using endoscopic ultrasound.

284 individuals (182 females). Subjects with history of pancreatic disease, hepatobiliary disease or gastrointestinal malignancy were excluded. 110 patients were found to have evidence of fatty pancreas.

Presence of fatty liver, visceral fat, hypertension, male gender and older age were associated with ultrasonographic evidence of fatty pancreas.

Heni et al. 2010 [54].

Germany

Cross sectional study using magnetic resonance imaging and magnetic resonance spectroscopy.

51 individuals (26 females) at risk for type 2 DM. 23 patients (14 females) were found to have pre-diabetes.

Greater BMI, waist circumference and visceral adipose tissue were associated with higher pancreatic fat content. Pancreatic fat was negatively associated with decreased insulin secretion in patients with pre-diabetes.

Sepe et al. 2011 [24].

USA

Prospective case control study using endoscopic ultrasound.

230 subjects (114 females) underwent endoscopic ultrasound. 64 individuals were found to have fatty pancreast (37 females).

Increased BMI and fatty liver were strongly associated with ultrasonographic evidence of fatty pancreas. No association was found between pancreatitis, pancreatic cancer and fatty pancreas.

Rossi et al. 2011 [47].

Italy

Cross sectional study using magnetic resonance imaging.

41 individuals (21 females). Subjects with fasting plasma glucose ≥7.0 mmol/l (≥126 mg/dl) and drinking >30 g/day for men and >20 g/day for women were excluded. 38 subjects were found to be obese (20 females).

Obese individuals had greater pancreatic fat content as well as other metabolic derangements such as visceral adiposity and fatty liver. Obese women had statistically lower amount of pancreatic and liver fat, visceral adiposity despite similar BMI. Visceral adipose tissue was found to be the strongest predictor for pancreatic and liver fat deposition.

Wu and Wang 2013 [21].

Taiwan

Cross-sectional study using trans abdominal ultrasound.

557 individuals (342 females) without history of hypertension and DM. 72 subjects (42 females) were found to have fatty pancreatic disease.

Older age, higher BMI and waist circumference, glycemic control, lipid parameters and systolic blood pressure were associated with the presence of fatty pancreas.

Ou et al. 2013 [57].

Taiwan

Cross-sectional study using trans abdominal ultrasonography.

7,464 subjects (2871 females). 483 patients were found to have DM (155 females). 18.1% of men and 14.2% of women were found to have fatty pancreas.

Fatty pancreas was found to be independently associated with pre-diabetes and DM in males.