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Nonalcoholic Fatty Pancreas Disease: Role in Metabolic Syndrome, “Prediabetes,” Diabetes and Atherosclerosis

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Abstract

Fat accumulation in the pancreas associated with obesity and the metabolic syndrome (MetS) has been defined as “non-alcoholic fatty pancreas disease” (NAFPD). The aim of this review is to describe the association of NAFPD with obesity, MetS, type 2 diabetes mellitus (T2DM) and atherosclerosis and also increase awareness regarding NAFPD. Various methods are used for the detection and quantification of pancreatic fat accumulation that may play a significant role in the differences that have been observed in the prevalence of NAFPD. Endoscopic ultrasound provides detailed images of the pancreas and its use is expected to increase in the future. Obesity and MetS have been recognized as NAFPD risk factors. NAFPD is strongly associated with non-alcoholic fatty liver disease (NAFLD) and it seems that the presence of both may be related with aggravation of NAFLD. A role of NAFPD in the development of “prediabetes” and T2DM has also been suggested by most human studies. Accumulation of fat in pancreatic tissue possibly initiates a vicious cycle of beta-cell deterioration and further pancreatic fat accumulation. Additionally, some evidence indicates a correlation between NAFPD and atherosclerotic markers (e.g., carotid intima–media thickness). Weight loss and bariatric surgery decreases pancreatic triglyceride content but pharmacologic treatments for NAFPD have not been evaluated in specifically designed studies. Hence, NAFPD is a marker of local fat accumulation possibly associated with beta-cell function impairment, carbohydrate metabolism disorders and atherosclerosis.

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  1. Metabolic Diseases Research Unit, Internal Medicine Laboratory, School of Medicine, Faculty of Medicine, University of Crete, P.O. Box 2208, Heraklion, Crete, Greece

    T. D. Filippatos, K. Alexakis & V. Mavrikaki

  2. Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, NW3 2QG, UK

    D. P. Mikhailidis

  3. Mohammed Bin Rashid University (MBRU) of Medicine and Health Sciences, Dubai, United Arab Emirates

    D. P. Mikhailidis

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TDF reports lecture honoraria from Boehringer Ingelheim, Mylan, Astra Zeneca, Lilly, Recordati, Bausch Health, Servier and Innovis. KA and VM report no conflicts of interest. DPM has given talks and attended conferences sponsored by Amgen, Novo Nordisk and Libytec.

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Filippatos, T.D., Alexakis, K., Mavrikaki, V. et al. Nonalcoholic Fatty Pancreas Disease: Role in Metabolic Syndrome, “Prediabetes,” Diabetes and Atherosclerosis. Dig Dis Sci 67, 26–41 (2022). https://doi.org/10.1007/s10620-021-06824-7

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