Pancreatic Steatosis Is Associated with Both Metabolic Syndrome and Pancreatic Stiffness Detected by Ultrasound Elastography

Objectives. To validate the ultrasound method of diagnosing visceral obesity in patients with cardiovascular diseases and metabolic syndrome. Material and methods. The study involved 115 people aged from 19 to 60 years, who represented a continuous random sample (examination sample). The diagnostic efficacy of shear wave ultrasound elastography of the lower perirenal visceral adipose tissue (VAT) was evaluated in 59 patients. Ultrasound examination was performed on the Logiq E9 ultrasound machine (GE Healthcare, USA); convex 3.5 MHz and linear 10.0 MHz sensors were used. Results. To assess visceral obesity, the following measurements are recommended: the area of the lower perirenal adipose tissue (AT), the distance between the surface of the rectus abdominis muscle and the anterior wall of the aorta, the thickness of the epicardial and pericardial AT, as well as the elastography of the lower part of the perirenal AT. According to the results of the performed validation of ultrasound VAT measuring techniques, the accuracy of visceral obesity diagnosing in patients with arterial hypertension with the use of the boundary values of the lower part perirenal AT area made up 87.8%. The accuracy of visceral obesity diagnosing in patients with coronary heart disease, taking into account the boundary values of the epicardial AT thickness equalled 86.2%, and pericardial AT thickness amounted to 95.4%. Diagnosing of visceral obesity in patients with metabolic syndrome by measuring four ultrasound parameters (area of the lower part of perirenal AT, thickness of intraabdominal AT, epicardial and pericardial VAT) was carried out with an accuracy of 86.1%. Elastic modulus determination during elastography of the lower part of the perirenal AT using the boundary values, established for patients with metabolic syndrome, was performed with an accuracy of 91.5%.

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A Comparison of the Sensitivity and Specificity of Ultrasound Elastography Compared to Liver Ultrasound, ALT, and AST in the Detection of Fatty Liver and Fibrosis in Patients with Metabolic Syndrome and Type 2 Diabetes Mellitus

Journal of the ASEAN Federation of Endocrine Societies ◽

10.15605/jafes.029.01.09 ◽

2014 ◽

Vol 29 (1) ◽

pp. 59-64 ◽

Cited By ~ 2

Author(s):

Andrea Marie Macabuag-Oliva ◽

◽

Maria Leonora Capellan ◽

Benjamin Benitez

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Metabolic Syndrome ◽

Type 2 Diabetes Mellitus ◽

Fatty Liver ◽

Sensitivity And Specificity ◽

Ultrasound Elastography ◽

Liver Ultrasound

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Pancreatic Steatosis: Is it Related to Obesity, Diabetes Mellitus and Metabolic Syndrome?

Pancreatic Disorders and Therapy ◽

10.4172/2165-7092.1000e139 ◽

2015 ◽

Vol 05 (03) ◽

Cited By ~ 1

Author(s):

Leonardo Roever

Keyword(s):

Diabetes Mellitus ◽

Metabolic Syndrome ◽

Pancreatic Steatosis

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Metabolic Pancreatitis: Pancreatic Steatosis, Hypertriglyceridemia, and Associated Chronic Pancreatitis in 3 Patients with Metabolic Syndrome

Case Reports in Gastroenterology ◽

10.1159/000490042 ◽

2018 ◽

Vol 12 (2) ◽

pp. 331-336 ◽

Cited By ~ 4

Author(s):

Constantine Melitas ◽

Mick Meiselman

Keyword(s):

Metabolic Syndrome ◽

Chronic Pancreatitis ◽

Subcutaneous Fat ◽

Alcohol Exposure ◽

Pancreatic Injury ◽

Patients At Risk ◽

History Of ◽

Valuable Marker ◽

Visceral Adipose ◽

Pancreatic Steatosis

Obesity, insulin resistance, and metabolic syndrome continue to increase in prevalence. Hypertriglyceridemia is commonly associated and represents a valuable marker of metabolic syndrome. An increase in subcutaneous fat deposition places patients at risk for visceral adipose deposition in sites such as the liver, heart, and pancreas. Pancreatic steatosis in the setting of metabolic syndrome is a rapidly emerging entity whose clinical spectrum remains to be defined. Hypertriglyceridemia is an accepted cause of acute pancreatitis but its role in chronic pancreatic injury remains to be explored. We present 3 patients with chronic abdominal pain and pancreatic steatosis in the setting of underlying metabolic syndrome with hypertriglyceridemia. These cases were identified in one endoscopic ultrasonographer’s practice over a 12-month period. Each patient had documented hypertriglyceridemia but no history of acute hypertriglyceride-induced pancreatitis. A history of significant alcohol exposure was carefully excluded. Each patient underwent endoscopic ultrasonography (EUS) which proved critical in delineating the spectrum of chronic pancreatic injury. Each of our patients had EUS documentation of pancreatic steatosis and sufficient criteria to establish a diagnosis of chronic pancreatitis. Intraductal pancreatic calculi were identified in all 3 patients. Our series suggests that in the setting of metabolic syndrome, chronic hypertriglyceridemia and pancreatic steatosis may be associated with chronic pancreatitis. We hypothesize that hypertriglyceridemia may provide a pathogenic role in the development of chronic pancreatic microinjury. In addition, each of our patients had EUS-documented pancreatic ductal lithiasis. To our review, these are novel findings which have yet to be reported. We believe that with an enhanced awareness, it is likely that the entity of metabolic syndrome with features of pancreatic steatosis and hypertriglyceridemia with their associated manifestations of chronic pancreatitis, including ductal lithiasis, will be widely appreciated.

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Metabolic tandem: non-alcoholic fatty liver disease and pancreatic steatosis; therapeutic significance of probiotics (clinical case)

Herald of Pancreatic Club ◽

10.33149/vkp.2020.03.09 ◽

2020 ◽

Vol 48 (3) ◽

pp. 70-75

Author(s):

O. O. Bondarenko ◽

M. I. Sorochka

Keyword(s):

Metabolic Syndrome ◽

Liver Disease ◽

Gut Microbiota ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Clinical Case ◽

Alcoholic Fatty Liver ◽

Pancreatic Steatosis ◽

Alcoholic Fatty Liver Disease

Non-communicable diseases are a serious global problem for humanity. Metabolic syndrome, cardiovascular disease, type 2 diabetes, obesity, and their complications lead to increased mortality and reduce quality of patients’ life. Non-alcoholic fatty liver disease (NAFLD) is currently recognized as one of the most common causes of chronic liver disease worldwide. Current scientific evidence suggests that there is a close relationship between the gut microbiota and chronic pathologies. The results of studies have established the existence of cause and effect relations between impaired microbiocenosis of the intestine, imbalance of the immune system, as well as in one of the key pathogenetic roles in the development and progression of NAFLD, pancreatic steatosis, increasing intestinal permeability, reducing the protective properties of mucosa, enhancing translocation of microorganisms into the systemic circulation. As no conventional approaches to the diagnosis and treatment of patients with NAFLD and metabolic syndrome have been developed at present, the therapy of such patients should be directed, first of all, to factors that contribute to their development and progression. Considering the latest research findings, the role of gut microbiota in the pathogenesis of metabolic syndrome is justified. The use of techniques affecting this correlation is substantiated. A promising method of treating such diseases is the prescription of pre- and probiotics to modify the gut microbiota. This article analyzes the case of a patient with NAFLD, pancreatic steatosis, who used a therapy that had an effect on the patient’s microbiota. The article contains system analysis, bibliosemantics, and case analysis of a specific patient. The sources were obtained from the scientific and statistical database of medical information. This clinical case highlights the relevance of this problem in medical practice and the feasibility of further research in this field. The impact of microbiome on human body is significant, and correcting disorders can reduce the risk of associated diseases. Therefore, preventing and correcting early-stage pathologies will reduce mortality rate and improve patients’ quality of life.

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Nonalcoholic Fatty Pancreas Disease: Clinical Consequences

Digestive Diseases ◽

10.1159/000505366 ◽

2019 ◽

Vol 38 (Suppl. 2) ◽

pp. 143-149 ◽

Cited By ~ 4

Author(s):

Petr Dite ◽

Martin Blaho ◽

Martina Bojkova ◽

Petr Jabandziev ◽

Lumir Kunovsky

Keyword(s):

Metabolic Syndrome ◽

Adult Population ◽

Developed Countries ◽

Sonographic Examination ◽

Pancreas Disease ◽

Pancreatic Fat ◽

Important Relationship ◽

Fatty Pancreas ◽

Clinical Consequences ◽

Pancreatic Steatosis

Metabolic syndrome and its components such as obesity, hypertriglyceridemia, type-2 diabetes mellitus (DM-T2), and arterial hypertension are unequivocally serious problems for every society. This is especially true in economically developed countries where the imbalance in lifestyle between caloric intake and caloric output still gets greater and greater. This fact is not only a concern for the adult population but for children as well. However, metabolic syndrome does not only affect society and health in regards to cardiovascular diseases, it significantly concerns gastroenterology where it is classified as nonalcoholic fatty pancreas disease (NAFPD). The data gained from several trials show that the prevalence of NAFDP is 33% (95% CI 24–41%). When it comes to the diagnostic procedures concerning the presence of pancreatic fat, a whole spectrum of suitable methods are recommended. Probably, the most exact method is the use of magnetic resonance imaging. However, for common clinical practice, the abdominal sonographic examination based on the comparison of the pancreatic parenchymatous echogenity versus renal or hepatic echogenity is used. The clinical consequences of pancreatic steatosis and steatopancreatitis are significant. These diseases are connected with DM-T2 and insulin resistance. In recent years, changes of exocrine pancreatic function, particularly its decrease, have also been described. It is known that there is a close correlation between NAFPD and nonalcoholic hepatic steatosis and also with the increased thickness of aortic intima-media. There is also an important relationship between NAFPD and pancreatic carcinoma. Pancreatic steatosis, and especially its NAFPD form, is a serious state which can be treatable by the possible effective management of metabolic syndrome parameters, including obesity.

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