Association between intra-pancreatic fat deposition and diseases of the exocrine pancreas: A narrative review

Table 3 Summary of intrapancreatic fat deposition treatment methods

Treatment method	Category	Mechanism of action	Research evidence	Ref.
Low-calorie diets	Non-pharmacological	Reduces insulin secretion and decreases adipose tissue accumulation in the pancreas and body	Evidence indicates that low-carbohydrate diets effectively diminish pancreatic and visceral fat deposition in individuals with obesity and type 2 diabetes	Taylor et al[122], 2018
Exercise	Non-pharmacological	Enhances overall insulin sensitivity and reduces pancreatic fat content	Numerous small clinical trials have demonstrated that physical activity can lower pancreatic fat deposition, regardless of the baseline glucose tolerance of participants	Heiskanen et al[121], 2018
Lactoferrin	Non-pharmacological	Improves lipid profiles, pancreatic function, and histological integrity	Supplementation with lactoferrin has been shown to mitigate weight gain, improve lipid levels, and enhance pancreatic function in models fed a high-fat diet	Hassan et al[123], 2022
Metformin	Pharmacological	Improves insulin resistance and reduces pancreatic and overall adipose tissue	In studies involving high-fat diet-fed mouse models, metformin significantly decreased pancreatic fat deposition and ameliorated insulin resistance	Souza-Mello et al[128], 2010
GLP-1 receptor agonists	Pharmacological	Stimulates insulin secretion, inhibits glucagon release, promotes weight loss, and decreases pancreatic fat	A growing body of clinical and preclinical evidence supports the efficacy of GLP-1 receptor agonists in reducing fat accumulation in both the pancreas and liver while enhancing pancreatic function	Kuriyama et al[131], 2024; Vanderheiden et al[130], 2016; Fang et al[46], 2021
SGLT-2 inhibitors	Pharmacological	Increases glucose excretion through urine, reduces lipogenesis, and improves pancreatic fat deposition	Research has demonstrated that SGLT-2 inhibitors, such as dapagliflozin, effectively improve body fat distribution and reduce pancreatic fat accumulation in patients with type 2 diabetes	Ghosh et al[133], 2022; Shi et al[132], 2023
DPP-4 inhibitors	Pharmacological	Enhances insulin secretion from pancreatic beta cells, suppresses glucagon secretion from alpha cells, and improves fat accumulation	Clinical trials and animal studies indicate that the DPP-4 inhibitor sitagliptin can effectively manage pancreatic steatosis and prevent the progression of pancreatic diseases	Souza-Mello et al[128], 2010; Nag et al[127], 2024
Statins	Pharmacological	Lowers blood lipid levels, inhibits pancreatic cell proliferation, and alleviates endoplasmic reticulum stress	Animal studies have demonstrated that statins significantly reduce pancreatic fat accumulation in models subjected to high-fat diets	Chen et al[138], 2014; Krisnamurti et al[137], 2022
Angiotensin II receptor blockers	Pharmacological	Mitigates intracellular calcium overload and lipid accumulation, improving insulin sensitivity and preventing fat degeneration	Various animal studies suggest that angiotensin II receptor blockers can alleviate pancreatic steatosis by enhancing metabolic conditions in diabetic patients	Souza-Mello et al[128], 2010; Lee et al[129], 2023

GLP-1: Glucagon-like peptide-1; DDP-4: Dipeptidyl peptidase-4; SGLT-2: Sodium-glucose co-transporter type 2.