Intrapancreatic fat deposition and nutritional treatment: the role of various dietary approaches

Diet-induced inflammation is associated with fatty pancreas in patients with common bile duct stones

Inflammation has been proven to be associated with chronic diseases. We hypothesized that higher diet-induced inflammation is associated with increased risk of fatty pancreas (FP). Among 278 patients with common bile duct (CBD) stones, 89 patients were diagnosed with fatty pancreas (case group) during endoscopic ultrasonography and the other 189 patients were healthy in this regard (control group). Dietary inflammatory index (DII), empirical dietary inflammatory pattern (EDIP) and dietary inflammatory score (DIS) were calculated based on a 168-question valid food frequency questionnaire. Dietary inflammatory scores were significantly higher in the case group than in the control group. Based on logistic regression analysis, higher scores of DII, EDIP and DIS were significantly associated with higher risk of FP in the crude and adjusted models. In the full adjusted models, higher scores of DII (OR T2 vs T1 = 1.36; 95% CI 0.71-2.58 and OR T3 vs T1 = 3.3; 95% CI: 1.59-6.8; P for trend = 0.001), EDIP (OR T2 vs T1 = 1.7; 95% CI 0.89-3.3 and OR T3 vs T1 = 2.5; 95% CI 1.2-5.1; P for trend = 0.009) and DIS (OR T2 vs T1 = 1.48; 95% CI 0.74-2.97 and OR T3 vs T1 = 2; 95% CI 1.16-3.63; P for trend = 0.040) resulted in increased risk of FP development. Diet-induced inflammation was associated with an increased propensity for developing fatty pancreas.

Linking abnormal fat distribution with HFpEF and diastolic dysfunction: a systematic review, meta-analysis, and meta-regression of observational studies

BACKGROUND

The global prevalence of obesity has escalated into a formidable health challenge intricately linked with the risk of developing cardiac diastolic disfunction and heart failure with preserved ejection fraction (HFpEF). Abnormal fat distribution is potentially strongly associated with an increased risk of cardiac diastolic dysfunction, and we aimed to scrutinize and elucidate the correlation between them.

METHODS

Following the Cochrane Handbook and PRISMA 2020 guidelines, we systematically reviewed the literature from PubMed, Embase, and Web of Science. We focused on studies reporting the mean and standard deviation (SD) of abnormal fat in HFpEF or cardiac diastolic dysfunction patients and the Pearson/Spearman correlation coefficients for the relationship between abnormal fat distribution and the risk of developing cardiac diastolic dysfunction. Data were standardized to the standard mean difference (SMD) and Fisher's z value for meta-analysis.

RESULTS

After progressive filtering and selection, 63 studies (43,113 participants) were included in the quantitative analyses. Abnormal fat distribution was significantly greater in participants with cardiac diastolic dysfunction than in controls [SMD 0.88 (0.69, 1.08)], especially in epicardial adipose tissue [SMD 0.99 (0.73, 1.25)]. Abnormal fat distribution was significantly correlated with the risk of developing cardiac diastolic dysfunction [E/E': 0.23 (0.18, 0.27), global longitudinal strain: r=-0.11 (-0.24, 0.02)]. Meta-regression revealed sample size as a potential heterogeneous source, and subgroup analyses revealed a stronger association between abnormal fat distribution and the risk of developing cardiac diastolic dysfunction in the overweight and obese population.

CONCLUSION

Abnormal fat distribution was significantly associated with the risk of developing cardiac diastolic dysfunction.

TRIAL REGISTRATION

CRD42024543774.

The Pharmacological Landscape for Fatty Change of the Pancreas

The quest for medications to reduce intra-pancreatic fat deposition is now quarter a century old. While no specific medication has been approved for the treatment of fatty change of the pancreas, drug repurposing shows promise in reducing the burden of the most common disorder of the pancreas. This leading article outlines the 12 classes of medications that have been investigated to date with a view to reducing intra-pancreatic fat deposition. Information is presented hierarchically-from preclinical studies to retrospective findings in humans to prospective interventional studies to randomised controlled trials. This lays the grounds for shepherding the most propitious drugs into medical practice through well-designed basic science studies and adequately powered randomised controlled trials.