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Ultrasonographic Nonalcoholic Fatty Pancreas Is Associated with Advanced Fibrosis in NAFLD: A Retrospective Analysis

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Abstract

Background

Nonalcoholic fatty pancreas disease (NAF-P) is strongly linked with nonalcoholic fatty liver disease (NAFLD), but its relationship with advanced liver disease is unknown.

Aims

This study investigated the association between NAF-P and both advanced fibrosis and nonalcoholic steatohepatitis (NASH).

Methods

This retrospective study evaluated adults with biopsy-proven NAFLD with a sonogram within 1 year of liver biopsy. NAF-P was diagnosed by comparing the echogenicity of the pancreas to the kidney and was graded by severity. The primary outcome was the effect of NAF-P on the presence of advanced fibrosis and NASH, while secondary outcomes included the association of extensive NAF-P (grade II/III). Propensity score matching for independent risk factors of advanced fibrosis (age, gender, body mass index, and diabetes) was performed.

Results

One hundred and four patients were included in the study and 91 (87.5%) had NAF-P. After propensity score matching, NAF-P was significantly associated with advanced fibrosis (OR 10.52, p < 0.001) but not NASH (p = 0.27). Extensive NAF-P was predictive of advanced fibrosis (OR 3.35, p = 0.006) and NASH (OR 5.37, p < 0.001). NAF-P had a negative predictive value (NPV) of 93% for advanced fibrosis. When matching for the NAFLD fibrosis score in addition to the variables above, both NAF-P (OR 5.36, p = 0.001) and extensive NAF-P (OR 5.38, p = 0.002) still significantly predicted advanced fibrosis.

Conclusion

NAF-P is predictive of advanced fibrosis, even when controlling for independent predictors of advanced fibrosis and the NAFLD fibrosis score. NAF-P has an excellent NPV and is a safe, inexpensive finding that can rule out advanced fibrosis.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA

    Russell Rosenblatt & Sonal Kumar

  2. Department of Medicine, Weill Cornell Medicine, 525 East 68th Street, New York, NY, 10021, USA

    Amit Mehta & David Snell

  3. Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA

    Erika Hissong

  4. Division of Radiology, Weill Cornell Medicine, 1305 York Avenue, 3rd Floor, New York, NY, 10021, USA

    Andrea Siobhan Kierans

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  1. Russell Rosenblatt
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  2. Amit Mehta
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  4. Erika Hissong
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  5. Andrea Siobhan Kierans
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  6. Sonal Kumar
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Corresponding author

Correspondence to Sonal Kumar.

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Conflict of interest

Sonal Kumar has received an advisory meeting honorarium from Gilead Sciences. The other authors have no conflicts to disclose.

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Rosenblatt, R., Mehta, A., Snell, D. et al. Ultrasonographic Nonalcoholic Fatty Pancreas Is Associated with Advanced Fibrosis in NAFLD: A Retrospective Analysis. Dig Dis Sci 64, 262–268 (2019). https://doi.org/10.1007/s10620-018-5295-x

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  • DOI: https://doi.org/10.1007/s10620-018-5295-x

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