Published online Jun 21, 2021. doi: 10.3748/wjg.v27.i23.3357
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
Abdominal adipose tissue distribution is an important factor in the pathogenesis of diabetes in general and new-onset diabetes after acute pancreatitis in particular.
The role of pancreatic enzymes in the pathogenesis of new-onset diabetes after acute pancreatitis is unknown.
The objective was to compare head-to-head abdominal adipose tissue distribution in new-onset prediabetes or diabetes after acute pancreatitis (NODAP), type 2 prediabetes or diabetes, and healthy controls.
The design was a case-control study. Intra-pancreatic fat, liver fat, skeletal muscle fat, visceral fat, and subcutaneous fat were quantified in a blinded fashion with the use of magnetic resonance imaging. Circulating levels of pancreatic amylase, pancreatic lipase, and chymotrypsin were determined.
The intra-pancreatic fat percentage was 9.4 ± 1.8%, 9.8 ± 1.1%, and 7.8 ± 1.9% in NODAP, type 2 prediabetes or diabetes, and healthy controls, respectively (P < 0.001). The visceral fat volume was 2205 ± 1098 cm3, 2622 ± 1172 cm3, and 1209 ± 808 cm3 in NODAP, type 2 prediabetes or diabetes, and healthy controls, respectively (P < 0.001). The other fat phenotypes did not differ between the groups. The amount of intra-pancreatic fat and visceral fat was significantly associated with circulating levels of pancreatic amylase in NODAP (but not type 2 prediabetes or diabetes or healthy controls).
Excess intra-pancreatic fat deposition is a key factor in the pathogenesis of new-onset diabetes after acute pancreatitis. There is a significant inverse relationship between circulating levels of pancreatic amylase and intra-pancreatic fat.
Human studies on the role of pancreatic amylase in new-onset diabetes after acute pancreatitis are warranted.