Longitudinal association of fatty pancreas with the incidence of type-2 diabetes in lean individuals: a 6-year computed tomography-based cohort study.
Journal
Journal of gastroenterology
Journal Volume
55
Journal Issue
7
Start Page
712-721
ISSN
1435-5922
Date Issued
2020-07
Author(s)
Yamazaki, Hajime
Tauchi, Shinichi
Dohke, Mitsuru
Hanawa, Nagisa
Kodama, Yoshihisa
Katanuma, Akio
Saisho, Yoshifumi
Kamitani, Tsukasa
Fukuhara, Shunichi
Yamamoto, Yosuke
Abstract
Background: Only a few studies have longitudinally evaluated whether fatty pancreas increases the risk of type-2 diabetes (T2D), and their results were inconsistent. Fatty pancreas is closely linked to overweight and obesity, but previous studies did not exclude overweight or obese individuals. Therefore, in this cohort study, we investigated the association between fatty pancreas and T2D incidence in lean individuals. Methods: Between 2008 and 2013, 1478 nondiabetic lean individuals (i.e. body-mass index < 25 kg/m2) underwent health examinations including computed tomography (CT) and were followed for a median of 6.19 years. Fatty pancreas was evaluated by a histologically-validated method using pancreas attenuation (Hounsfield units [HU]) on CT at baseline; lower pancreas attenuation indicates more pancreatic fat. To detect incident T2D, we used fasting plasma glucose, HbA1c, and self-reports of prescribed anti-diabetes medications. Odds ratios (OR) for the association between pancreas attenuation and incident T2D were estimated using logistic regression models adjusted for likely confounders. Results: T2D occurred in 61 participants (4.13%) during the follow-up period. Lower pancreas attenuation (i.e. more pancreatic fat) at baseline was associated with incident T2D (unadjusted OR per 10 HU lower attenuation: 1.56 [95% CI 1.28–1.91], p < 0.001). The multivariable-adjusted analysis revealed a similar association (adjusted OR per 10 HU lower attenuation: 1.32 [95% CI 1.06–1.63], p = 0.012). Conclusions: T2D was likely to develop in lean individuals with the fatty pancreas. Among people who are neither obese nor overweight, the fatty pancreas can be used to define a group at high risk for T2D.
Subjects
Cohort
Diabetes mellitus
Fatty pancreas
Pancreatic fat
Type-2 diabetes
SDGs
Publisher
Springer
Type
journal article