Pancreatic Steatosis in Patients with Pheochromocytoma and Paraganglioma: A Retrospective Single-Center Study

<b>Background/Objectives</b>: This study aimed to evaluate pancreatic steatosis and its association with the triglyceride index in patients with pheochromocytoma and paraganglioma (PPGL). <b>Methods:</b> In this retrospective single-center study conducted between 2 January 2019 and 30 April 2024, thirty-three patients with confirmed PPGL and thirty-three age-, sex-, and body mass index (BMI)-matched healthy controls were evaluated. The mean age of the study population was 49.7 ± 12.3 years, and 32 participants (48.5%) were female. Pancreatic fat infiltration was assessed via computed tomography (CT). Body composition parameters, including visceral fat area (VFA), subcutaneous fat area (SFA), skeletal muscle area (SMA), and skeletal muscle area index (SMAI), were also measured. Laboratory data, including lipid profiles, glucose, hemoglobin A1c (HbA1c), and triglyceride index (TyG), were analyzed. <b>Results:</b> Pancreatic steatosis, as indicated by significantly lower pancreatic attenuation values, was markedly higher in the PPGL group compared to controls (<i>p</i> < 0.001). No significant differences were observed between the groups in terms of VFA (<i>p</i> = 0.218), SFA (<i>p</i> = 0.413), SMA (<i>p</i> = 0.669), or SMAI (<i>p</i> = 0.562). Pancreatic fat was positively correlated with triglyceride levels, VLDL, TyG index, BMI, and VFA. No correlation was found between catecholamine levels and pancreatic steatosis. <b>Conclusions</b>: Our findings indicate an increase in pancreatic steatosis in patients with PPGL, suggesting a potential association between catecholamine excess and the development of ectopic fat deposition. These results support considering pancreatic fat as a marker of metabolic dysfunction in PPGL.