Fatty pancreas and its relation to insulin resistance and adiponectin level in non-diabetic patients

Fatty pancreas is characterized by parenchymal fat infiltration without significant alcohol consumption. Multiple abdominal ultrasonography imaging studies have documented the prevalence of fatty pancreas ranging from 16 to 35%. Recent years have witnessed accumulating evidence substantiating the fatty pancreas association with multiple comorbid diseases as diabetes mellitus and metabolic syndrome. Numerous studies have established the determining role of adiponectin in carbohydrate and lipid metabolism, particularly within the liver and muscle, alongside energy homeostasis, plus its anti-atherogenic and anti-inflammatory properties. Impaired target tissue biologic response to insulin stimulation defines insulin resistance. Establish the associations among serum adiponectin concentrations, insulin resistance, and fatty pancreas. Between June 2023 and September 2024, the current case-control study included 45 Egyptian patients with fatty pancreas recruited from the internal medicine outpatient department at Kasr Al Ainy Hospital School of Medicine, Cairo University, alongside 45 age- and sex-matched healthy controls. All patients and controls underwent pelvi-abdominal ultrasonography, HbA1c, HOMA-IR, serum adiponectin, lipid profile, and routine laboratory investigations. Significant correlations characterize the relationship between insulin resistance and fatty pancreas, with fatty pancreas patients demonstrating significantly elevated low-density lipoprotein and cholesterol levels compared with healthy controls (P value < 0.001). Adiponectin levels are lower in patients with fatty pancreas than in healthy controls, though the difference is not statistically significant. Fatty liver is present in more than half of patients with fatty pancreas (66.7%). Differences in adiponectin levels between individuals with and without insulin resistance lack statistical significance. Significant correlations characterize the relationship between insulin resistance and fatty pancreas. Fatty liver has a strong correlation with fatty pancreas. Elevated LDL levels and high BMI constitute the most significant fatty pancreas predictors.