Effects of Lifestyle Modification on Intrapancreatic Fat Deposition: A Systematic Review and Meta-Analysis

Lifestyle modification is a well-established approach for improving metabolic health and reducing ectopic fat accumulation in the liver. The Melbourne Consensus has recently highlighted intrapancreatic fat deposition (IPFD) as an important fat depot, playing a key role in the development of both endocrine and exocrine pancreatic diseases. Nevertheless, the existing literature on the impact of lifestyle modification on IPFD has not been systematically synthesized. We conducted a comprehensive systematic review and meta-analysis to assess the effects of lifestyle modification on IPFD.

A systematic literature search was conducted in PubMed and Embase databases to identify interventional studies evaluating the effects of lifestyle modification on IPFD measured by magnetic resonance-based techniques. Data were meta-analyzed using a random-effects model. Statistical heterogeneity was assessed using the I² statistic, and publication bias was evaluated with Egger's test.

A total of 23 studies were included. Lifestyle modification resulted in a significant reduction in IPFD (standardized mean difference [SMD] -0.26, 95% CI -0.36 to -0.16; p<0.0001), with low heterogeneity (I²=12.9%). The pooled absolute reduction in MRI-measured IPFD was -1.02 % (95% CI -1.30 to -0.73; p<0.0001), with no evidence of heterogeneity (I²=0%). Subgroup analyses showed the largest numerical reduction in IPFD with combined diet-and-exercise interventions (SMD -0.41, 95% CI -0.81 to -0.02, I²=29.4%), followed by exercise alone (SMD -0.26, 95% CI -0.36 to -0.15, I²=0%) and diet alone (SMD -0.22, 95% CI -0.37 to -0.08, I²=27.9%). However, differences between intervention types were not statistically significant (p=0.40). There was no evidence of publication bias (p = 0.78).

Lifestyle modification is an effective non-pharmacological approach for reducing IPFD, with combined diet-and-exercise interventions showing the largest numerical effect. These findings support the potential of structured lifestyle modification programs to reduce IPFD and may have implications for the prevention and management of pancreatic diseases.