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Exploring the metabolic syndrome: Nonalcoholic fatty pancreas disease

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ABSTRACT

After the first description of fatty pancreas in 1933, the effects of pancreatic steatosis have been poorly investigated, compared with that of the liver. However, the interest of research is increasing. Fat accumulation, associated with obesity and the metabolic syndrome (MetS), has been defined as “fatty infiltration” or “nonalcoholic fatty pancreas disease” (NAFPD). The term “fatty replacement” describes a distinct phenomenon characterized by death of acinar cells and replacement by adipose tissue. Risk factors for developing NAFPD include obesity, increasing age, male sex, hypertension, dyslipidemia, alcohol and hyperferritinemia. Increasing evidence support the role of pancreatic fat in the development of type 2 diabetes mellitus, MetS, atherosclerosis, severe acute pancreatitis and even pancreatic cancer. Evidence exists that fatty pancreas could be used as the initial indicator of “ectopic fat deposition”, which is a key element of nonalcoholic fatty liver disease and/or MetS. Moreover, in patients with fatty pancreas, pancreaticoduodenectomy is associated with an increased risk of intraoperative blood loss and post-operative pancreatic fistula.

No MeSH data available.


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Pancreatic steatosis. Courtesy of Prof. Vasquez E and Dr. Angelico G, Anatomical Pathology Department, University of Catania -Catania, Italy.
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Figure 2: Pancreatic steatosis. Courtesy of Prof. Vasquez E and Dr. Angelico G, Anatomical Pathology Department, University of Catania -Catania, Italy.

Mentions: Unlike the liver, where the triglycerides accumulation is mainly intracellular, pancreatic steatosis is histologically characterized by an increased number of adipocytes (Figures 2 and 3)[5,16]. However, intracellular fat accumulation can be visualized by electronic microscopy or immunohistochemistry in both acinar and islet cells and may precede adipocytes infiltration[12,13,16,18,21,23,45-48]. It is unknown if intracellular or extracellular triglycerides have a different clinical significance, but it is possible that adipocytes influence the function of acinar and/or islet cells by a paracrine effect, while intracellular lipids may lead to lipotoxicity and therefore islet or acinar cells injury, as further discussed[9].


Exploring the metabolic syndrome: Nonalcoholic fatty pancreas disease
Pancreatic steatosis. Courtesy of Prof. Vasquez E and Dr. Angelico G, Anatomical Pathology Department, University of Catania -Catania, Italy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016366&req=5

Figure 2: Pancreatic steatosis. Courtesy of Prof. Vasquez E and Dr. Angelico G, Anatomical Pathology Department, University of Catania -Catania, Italy.
Mentions: Unlike the liver, where the triglycerides accumulation is mainly intracellular, pancreatic steatosis is histologically characterized by an increased number of adipocytes (Figures 2 and 3)[5,16]. However, intracellular fat accumulation can be visualized by electronic microscopy or immunohistochemistry in both acinar and islet cells and may precede adipocytes infiltration[12,13,16,18,21,23,45-48]. It is unknown if intracellular or extracellular triglycerides have a different clinical significance, but it is possible that adipocytes influence the function of acinar and/or islet cells by a paracrine effect, while intracellular lipids may lead to lipotoxicity and therefore islet or acinar cells injury, as further discussed[9].

View Article: PubMed Central - PubMed

ABSTRACT

After the first description of fatty pancreas in 1933, the effects of pancreatic steatosis have been poorly investigated, compared with that of the liver. However, the interest of research is increasing. Fat accumulation, associated with obesity and the metabolic syndrome (MetS), has been defined as “fatty infiltration” or “nonalcoholic fatty pancreas disease” (NAFPD). The term “fatty replacement” describes a distinct phenomenon characterized by death of acinar cells and replacement by adipose tissue. Risk factors for developing NAFPD include obesity, increasing age, male sex, hypertension, dyslipidemia, alcohol and hyperferritinemia. Increasing evidence support the role of pancreatic fat in the development of type 2 diabetes mellitus, MetS, atherosclerosis, severe acute pancreatitis and even pancreatic cancer. Evidence exists that fatty pancreas could be used as the initial indicator of “ectopic fat deposition”, which is a key element of nonalcoholic fatty liver disease and/or MetS. Moreover, in patients with fatty pancreas, pancreaticoduodenectomy is associated with an increased risk of intraoperative blood loss and post-operative pancreatic fistula.

No MeSH data available.


Related in: MedlinePlus