Pancreatic Steatosis: Innocent Bystander or Silent Culprit?

Pancreatic steatosis (PS) is characterized by fat accumulation within the pancreas and is associated with chronic low-grade inflammation. Migraine, the third most commonly seen disease worldwide, is an established risk factor for white matter lesions (WMLs). Given the shared inflammatory background of these conditions, it was hypothesized that the presence of PS in patients with migraine may contribute to the development of WMLs.

This cross-sectional study included patients with migraine who attended the outpatient clinic and had undergone cranial magnetic resonance imaging (MRI) scan for any indication within the last 6 months. Following MRI, patients were referred to the radiology department for transabdominal ultrasonography to assess the presence of PS and hepatosteatosis.

Among the 78 patients with migraine included in the study, 35 (44.9%) had cranial WMLs. PS was significantly more prevalent among patients with WMLs than among those without WMLs (57.4% vs. 16.7%, P < .001). In multivariable logistic regression analysis adjusted for age, body mass index, and low-density lipoprotein/high-density lipoprotein ratio, PS remained independently associated with cranial WMLs (odds ratio (OR) 5.79, 95% CI 1.004-33.41; P = .049). Increasing age was also independently associated with WMLs (OR 1.095 per year, 95% CI 1.018-1.179; P = .015).

This study demonstrated that the presence of PS may contribute to disease burden in patients with migraine. Evaluation of PS in this population may help identify a potentially modifiable metabolic condition and provide additional insight into the management of this common and debilitating disorder.