Association of pancreatic fat content with type II diabetes mellitus

•Pancreatic fat can be easily discerned on routine MRI of the abdomen.•Fat content in pancreatic head was the best predictor of developing type II diabetes mellitus.•In type II diabetic patients, pancreatic fat content was not associated with glycemic control. AIMTo determine the association between regional fat content in the pancreas and the presence or absence of type II diabetes mellitus (T2DM), the value of regional pancreatic fat quantification in identifying patients at risk of T2DM, and whether pancreatic fat content is associated with glycaemic control in T2DM.MATERIALS AND METHODSA retrospective survey of a radiology database identified 45 patients with T2DM, and 81 “at risk for T2DM” patients who developed diabetes, between 0.6 and 3.7 years after magnetic resonance imaging (MRI). A control group who did not develop diabetes during a 5-year follow-up and without known metabolic syndrome, liver, or pancreatic diseases were also identified. Fat content was measured by placing regions of interest (ROIs) on in-phase and out-of-phase chemical shift MRI images. Multiple clinical parameters including body mass index, cholesterol levels, blood pressure, glycated haemoglobin (HbA1c; in T2DM group) were collected.RESULTSThere was a significant difference between the T2DM and control groups for fat fraction in the pancreatic head (p=0.043), body (p=0.015), and tail (p=0.001), but not liver (p=0.107). On regression analysis, only the fat fraction within the pancreatic tail was significantly different between control group and “at risk” for T2DM group (p=0.007). A pancreatic tail fat content of >10% had a sensitivity of 45.5% and specificity of 81.3% for predicting development of T2DM within 4 years. Pancreatic fat content was not associated with glycaemic control.CONCLUSIONSIncreased fat in the pancreatic tail may identify patients at risk for T2DM. To determine the association between regional fat content in the pancreas and the presence or absence of type II diabetes mellitus (T2DM), the value of regional pancreatic fat quantification in identifying patients at risk of T2DM, and whether pancreatic fat content is associated with glycaemic control in T2DM. A retrospective survey of a radiology database identified 45 patients with T2DM, and 81 “at risk for T2DM” patients who developed diabetes, between 0.6 and 3.7 years after magnetic resonance imaging (MRI). A control group who did not develop diabetes during a 5-year follow-up and without known metabolic syndrome, liver, or pancreatic diseases were also identified. Fat content was measured by placing regions of interest (ROIs) on in-phase and out-of-phase chemical shift MRI images. Multiple clinical parameters including body mass index, cholesterol levels, blood pressure, glycated haemoglobin (HbA1c; in T2DM group) were collected. There was a significant difference between the T2DM and control groups for fat fraction in the pancreatic head (p=0.043), body (p=0.015), and tail (p=0.001), but not liver (p=0.107). On regression analysis, only the fat fraction within the pancreatic tail was significantly different between control group and “at risk” for T2DM group (p=0.007). A pancreatic tail fat content of >10% had a sensitivity of 45.5% and specificity of 81.3% for predicting development of T2DM within 4 years. Pancreatic fat content was not associated with glycaemic control. Increased fat in the pancreatic tail may identify patients at risk for T2DM.