Case Control Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 21, 2021; 27(23): 3357-3371
Published online Jun 21, 2021. doi: 10.3748/wjg.v27.i23.3357
Pancreatic enzymes and abdominal adipose tissue distribution in new-onset prediabetes/diabetes after acute pancreatitis
Juyeon Ko, Loren Skudder-Hill, Jaelim Cho, Sakina H Bharmal, Maxim S Petrov
Juyeon Ko, Loren Skudder-Hill, Jaelim Cho, Sakina H Bharmal, Maxim S Petrov, School of Medicine, University of Auckland, Auckland 1142, New Zealand
Author contributions: Ko J, Skudder-Hill L, Cho J, and Bharmal SH collected data; Ko J wrote the manuscript; Ko J, Skudder-Hill L, Cho J, Bharmal SH, and Petrov MS reviewed the manuscript; Petrov MS conceived and supervised the study.
Institutional review board statement: The study was approved by the Health and Disability Ethics Committee (New Zealand).
Informed consent statement: All study participants or their legal guardians provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors have no conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maxim S Petrov, MD, MPH, PhD, Professor, School of Medicine, University of Auckland, 28 Park Avenue, Auckland 1142, New Zealand. m.petrov@auckland.ac.nz
Received: January 29, 2021
Peer-review started: January 29, 2021
First decision: April 5, 2021
Revised: April 14, 2021
Accepted: June 7, 2021
Article in press: June 7, 2021
Published online: June 21, 2021
Abstract
BACKGROUND

New-onset prediabetes/diabetes after acute pancreatitis (NODAP) is the most common sequela of pancreatitis, and it differs from type 2 prediabetes/diabetes mellitus (T2DM).

AIM

To study the associations between circulating levels of pancreatic amylase, pancreatic lipase, chymotrypsin and fat phenotypes in NODAP, T2DM, and health.

METHODS

Individuals with NODAP (n = 30), T2DM (n = 30), and sex-matched healthy individuals (n = 30) were included. Five fat phenotypes (intra-pancreatic fat, liver fat, skeletal muscle fat, visceral fat, and subcutaneous fat) were determined using the same magnetic resonance imaging protocol and scanner magnet strength for all participants. One-way analysis of covariance, linear regression analysis, and relative importance analysis were conducted.

RESULTS

Intra-pancreatic fat deposition (IPFD) was higher in NODAP (9.4% ± 1.8%) and T2DM (9.8% ± 1.1%) compared with healthy controls (7.8% ± 1.9%) after adjusting for covariates (P = 0.003). Similar findings were observed in regards to visceral fat volume (P = 0.005), but not subcutaneous fat volume, liver fat, or skeletal muscle fat. Both IPFD (β = -2.201, P = 0.023) and visceral fat volume (β = -0.004, P = 0.028) were significantly associated with circulating levels of pancreatic amylase in NODAP, but not in T2DM or healthy individuals. Of the five fat phenotypes, IPFD explained the highest amount of variance in pancreatic amylase concentration (R2 = 15.3% out of 41.2%). None of the phenotypes contributed meaningfully to the variance in pancreatic lipase or chymotrypsin.

CONCLUSION

Both NODAP and T2DM are characterized by increased IPFD and visceral fat volume. However, only NODAP is characterized by significant inverse associations between the two fat phenotypes and pancreatic amylase.

Keywords: Amylase, Lipase, Chymotrypsin, Pancreatitis, Diabetes, Intra-pancreatic fat, Visceral fat, Liver fat

Core Tip: Intra-pancreatic fat deposition and visceral fat volume are significantly inversely associated with circulating levels of pancreatic amylase in individuals with new-onset prediabetes/diabetes after acute pancreatitis, but not in healthy individuals or those with type 2 prediabetes/diabetes mellitus.