| Title: | Fatty Pancreas and Risk of Type 2 Diabetes, Chronic Kidney Disease and Cardiovascular Events: Evidence From a Population-Based Cohort |
| Journal: | United European Gastroenterology Journal |
| Published: | 2 Jul 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42390998/ |
| DOI: | https://doi.org/10.1002/ueg2.70253 |
Publication 20682
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Abstract
BACKGROUND: Fatty pancreas is a metabolically active ectopic fat depot, but its cardiometabolic implications have been assessed using heterogeneous thresholds. We investigated the association of fatty pancreas, quantified using MRI-derived proton density fat fraction (PDFF) and categorised according to 2026 international consensus thresholds, with prevalent and incident type 2 diabetes (T2D), chronic kidney disease (CKD) and major adverse cardiovascular events (MACE).</p>
METHODS: We analysed 19,255 European-ancestry participants from the UK Biobank imaging sub-study. Pancreatic PDFF was categorised as normal (< 6%), mild (6 to < 16%) and moderate-to-severe fatty pancreas (≥ 16%). Outcomes were ascertained through national health records. Associations were estimated using multivariable logistic regression and Cox models, adjusted for age, sex, BMI-defined obesity, elevated MRI-derived visceral adipose tissue and outcome-specific covariates.</p>
RESULTS: Moderate-to-severe fatty pancreas was associated with prevalent and incident T2D (OR 3.25, 95% CI 2.49-4.27; p < 0.001; HR 2.72, 1.66-4.46; p < 0.001), incident CKD (HR 1.82, 1.29-2.57; p < 0.001), and prevalent and incident MACE (OR 1.26, 1.04-1.56; p = 0.022; HR 1.30, 1.02-1.66; p = 0.034). Mild fatty pancreas was associated with incident T2D (HR 2.19, 1.40-3.42; p < 0.001) and incident MACE (HR 1.29, 1.06-1.59; p = 0.013). Each 5% increase in pancreatic PDFF was associated with higher odds and hazard of T2D (OR 1.16, 1.12-1.21; HR 1.17, 1.09-1.25; both p < 0.001).</p>
CONCLUSIONS: Fatty pancreas was independently associated with prevalent and incident T2D, incident CKD and, more modestly, with MACE. These findings position fatty pancreas within the cardiovascular-kidney-metabolic continuum and support the clinical relevance of consensus-based PDFF thresholds for cardiometabolic risk assessment in European-ancestry populations.</p>
19 Keywords
- Adult
- Aged
- Cardiovascular Diseases
- Cohort Studies
- Diabetes Mellitus, Type 2
- Female
- Humans
- Incidence
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Pancreas
- Pancreatic Diseases
- Prevalence
- Renal Insufficiency, Chronic
- Risk Assessment
- Risk Factors
- UK Biobank
- United Kingdom
7 Authors
- Nicola Pugliese
- Oveis Jamialahmadi
- Arturo Cesaro
- Valentina Flagiello
- Rosellina M. Mancina
- Alessio Aghemo
- Stefano Romeo
1 Application
| Application ID | Title |
|---|---|
| 37142 | UNDERSTANDING THE GENETIC ARCHITECTURE OF CHRONIC LIVER DISEASE |
Enabling scientific discoveries that improve human health