Hajime Yamazaki1, Toru Tsuboya2, Akio Katanuma3, Yoshihisa Kodama4, Shinichi Tauchi5, Mitsuru Dohke6, Hiroyuki Maguchi3. 1. Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan yamazaki-myz@umin.ac.jp. 2. 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. 3. Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan. 4. Department of Radiology, Teine Keijinkai Hospital, Sapporo, Japan. 5. Department of Radiology, Keijinkai Maruyama Clinic, Sapporo, Japan. 6. Department of Health Checkup and Promotion, Keijinkai Maruyama Clinic, Sapporo, Japan.
Abstract
OBJECTIVE: 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. RESEARCH DESIGN AND METHODS: 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. RESULTS: 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]). CONCLUSIONS: Fatty pancreas was not independently associated with future T2DM.
OBJECTIVE: 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. RESEARCH DESIGN AND METHODS: 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. RESULTS: 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]). CONCLUSIONS:Fatty pancreas was not independently associated with future T2DM.
Authors: Robert Wagner; Sabine S Eckstein; Hajime Yamazaki; Felicia Gerst; Jürgen Machann; Benjamin Assad Jaghutriz; Annette Schürmann; Michele Solimena; Stephan Singer; Alfred Königsrainer; Andreas L Birkenfeld; Hans-Ulrich Häring; Andreas Fritsche; Susanne Ullrich; Martin Heni Journal: Nat Rev Endocrinol Date: 2021-10-20 Impact factor: 43.330
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