Non-alcoholic fatty pancreas disease and pancreatic exocrine insufficiency: pilot study and systematic review

IntroductionThe prevalence of non-alcoholic fatty pancreas disease (NAFPD) is estimated as 2-46% among patients without known pancreatic diseases. An association between NAFPD and non-alcoholic fatty liver disease (NAFLD) has been proposed, as well as an association between NAFPD and pancreatic exocrine insufficiency (PEI).Patients and methodsPatients with histologically confirmed NAFLD were included in the study. The control group consisted of individuals included in a surveillance screening program. Magnetic resonance imaging (MRI) of the pancreas was performed in all patients and fat measurement was made using 2-point Dixon imaging. Fecal elastase-1 (FE-1) was performed to evaluate pancreatic exocrine function. Additionally, a C-13-mixed triglyceride breath test (13 C-MTG-BT) was performed in patients with FE-1 < 200 mu g/g.ResultsImaging signs of NAFPD were present in 17 (71%) patients; 11 (85%) from the NAFLD group and 6 (55%) from the control group. FE-1 < 200 mu g/g was found in six (25%) patients (four in the NAFLD group and two in the control group); however, none of them had clinical symptoms of PEI. Therefore, in five out of six patients with low FE-1, a C-13-MTG-BT was performed, showing normal results (>20.9%) in all tested patients. Furthermore, the serum nutritional panel was normal in all patients with low FE-1. A systematic review identified five studies relevant to the topic.ConclusionNAFPD was found in 85% of patients with NAFLD and in 55% of control patients. We did not diagnose PEI in either group. A literature review showed PEI in 9-56% of patients with NAFPD.

Automated summary

This study found that the prevalence of non-alcoholic fatty pancreas disease (NAFPD) was 85% in patients with non-alcoholic fatty liver disease (NAFLD) and 55% in the control group. However, PEI was not diagnosed in either group. A literature review identified PEI in 9-56% of NAFPD patients.