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Published on: January 29, 2018
Association of pancreatic fat on imaging with pediatric metabolic co-morbidities
Sarah E Swauger1,2, Kaity Fashho3, Lindsey N Hornung4
1Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Swauger1989@gmail.com.
Insights
Pancreatic fat is higher in children with obesity and those with endocrine or exocrine dysfunctions. This finding links pancreatic fat to metabolic health issues in pediatric patients.
Area of Science:
- Pediatric Radiology
- Metabolic Health
- Endocrinology
Background:
- The link between pancreatic fat and metabolic co-morbidities is not well-established in pediatric populations.
- Investigating this relationship is crucial for understanding metabolic health in children.
Purpose of the Study:
- To determine the relationship between pancreatic fat, measured via MRI, and endocrine/exocrine dysfunctions.
- To explore associations between pancreatic fat and metabolic co-morbidities in a pediatric cohort.
Main Methods:
- Retrospective review of 136 pediatric patients who underwent MRI.
- Pancreatic fat quantified using MRI proton density fat fraction (PDFF) sequence.
- Laboratory studies and clinical information reviewed for endocrine/exocrine status and metabolic co-morbidities.
Main Results:
- Elevated pancreatic fat fraction observed in patients with exocrine conditions (3.5% vs 2.2%, p=0.03).
- Higher pancreatic head fat fraction in patients with endocrine insufficiency (3.5% vs 2.0%, p=0.04).
- Increased pancreatic fat fraction correlated with BMI > 85% across all pancreatic regions.
Conclusions:
- Pancreatic fat is significantly elevated in pediatric patients with obesity (BMI > 85%).
- Increased pancreatic fat is associated with both exocrine and endocrine insufficiencies in children.
- These findings highlight pancreatic fat as a potential imaging biomarker for metabolic dysfunction in pediatrics.
Background:
The relationship between pancreatic fat on imaging and metabolic co-morbidities has not been established in pediatrics. We sought to investigate the relationship between pancreatic fat measured by MRI and endocrine/exocrine dysfunctions along with the metabolic co-morbidities in a cohort of children.
Objective:
To investigate relationships between pancreatic fat quantified by MRI and endocrine and exocrine conditions and metabolic co-morbidities in a cohort of children. MATERIALS AND METHODS: This was a retrospective review of pediatric patients (n = 187) who had a clinically indicated MRI examination between May 2018 and February 2020. After 51 patients without useable imaging data were excluded, the remaining 136 subjects comprised the study sample. Laboratory studies were assessed if collected within 6 months of MRI and patient charts were reviewed for demographic and clinical information. MRI proton density fat fraction (PDFF) sequence had been acquired according to manufacturer's specified parameters at a slice thickness of 3 mm. Two blinded radiologists independently collected PDFF data.
Results:
The median age at MRI was 12.1 (IQR: 9.0-14.8) years and the majority of patients were Caucasian (79%), followed by African American and Hispanic at 12% and 11% respectively. There was a higher median pancreas fat fraction in patients with exocrine conditions (chronic pancreatitis or exocrine insufficiency) compared to those without (3.5% vs 2.2%, p = 0.03). There was also a higher median fat fraction in the head of pancreas in patients with endocrine insufficient conditions (insulin resistance, pre-diabetes, type 1 and type 2 diabetes) compared to those without endocrine insufficiency when excluding patients with active acute pancreatitis (3.5% vs 2.0%, p = 0.04). Patients with BMI > 85% had higher mean fat fraction compared to patients with BMI ≤ 85% (head: 3.8 vs 2.4%, p = 0.01; body: 3.8 vs 2.5%, p = 0.005; tail: 3.7 vs 2.7%, p = 0.049; overall pancreas fat fraction: 3.8 vs 2.6%, p = 0.002).
Conclusion:
Pancreas fat is elevated in patients with BMI > 85% and in those with exocrine and endocrine insufficiencies.
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