Case Control Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Nov 28, 2016; 8(33): 1452-1458
Published online Nov 28, 2016. doi: 10.4254/wjh.v8.i33.1452
Pancreatic hyperechogenicity associated with hypoadiponectinemia and insulin resistance: A Japanese population study
Naohiko Makino, Nakao Shirahata, Teiichiro Honda, Yoshiaki Ando, Akiko Matsuda, Yushi Ikeda, Miho Ito, Yuko Nishise, Takafumi Saito, Yoshiyuki Ueno, Sumio Kawata
Naohiko Makino, Nakao Shirahata, Teiichiro Honda, Yoshiaki Ando, Akiko Matsuda, Yushi Ikeda, Miho Ito, Yuko Nishise, Takafumi Saito, Yoshiyuki Ueno, Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata 990-9585, Japan
Sumio Kawata, Department of Internal Medicine, Hyogo Prefectural Nishinomiya Hospital, Hyogo 662-0918, Japan
Author contributions: Makino N and Kawata S designed the research; Shirahata N, Honda T, Ando Y, Matsuda A, Ikeda Y, Ito M, Nishise Y, Saito T and Ueno Y performed the research; Makino N wrote the paper.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Yamagata University Faculty of Medicine.
Informed consent statement: All participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
Correspondence to: Naohiko Makino, MD, PhD, Associate Professor, Department of Gastroenterology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. namakino@med.id.yamagata-u.ac.jp
Telephone: +81-23-6285307 Fax: +81-23-6285311
Received: June 27, 2016
Peer-review started: June 28, 2016
First decision: August 22, 2016
Revised: September 8, 2016
Accepted: October 17, 2016
Article in press: October 18, 2016
Published online: November 28, 2016
Abstract
AIM

To examine the relationship between pancreatic hyperechogenicity and risk factors for metabolic syndrome.

METHODS

A general population-based survey of lifestyle-related diseases was conducted from 2005 to 2006 in Japan. The study involved 551 participants older than 40 year of age. Data for 472 non-diabetic adults were included in the analysis. The measures included the demographic factors, blood parameters, results of a 75 g oral glucose tolerance test, and abdominal ultrasonography. The echogenicity of the pancreas and liver was compared, and then the subjects were separated into two groups: cases with pancreatic hyperechogenicity (n = 208) and cases without (controls, n = 264). The differences between both groups were compared using an unpaired t-test or Fisher’s exact test. Multiple logistic regression analysis was used to determine the relationship between the pancreatic hyperechogenicity and clinical and biochemical parameters.

RESULTS

Subjects with pancreatic hyperechogenicity had decreased serum adiponectin concentration compared to control subjects [8.9 (6.5, 12.8) vs 11.1 (7.8, 15.9), P < 0.001] and more frequently exhibited features of metabolic syndrome. Logistic regression analysis showed that the following variables were significantly and independently associated with pancreatic hyperechogenicity: Presence of hypoadiponectinemia, increased body mass index (BMI), higher homeostasis model assessment of insulin resistance (HOMA-IR) score, and presence of fatty liver. Similar associations were also observed in subjects with pancreatic hyperechogenicity without fatty liver. Multivariate association analysis of data from participants without fatty liver showed that hypoadiponectinemia was significantly associated with pancreatic hyperechogenicity (OR = 0.93, 95%CI: 0.90 - 0.97, P < 0.001). This association was independent of other confounding variables. Additionally, an increased BMI and higher HOMA-IR score were significantly associated with pancreatic hyperechogenicity.

CONCLUSION

Pancreatic hyperechogenicity is independently associated with increased BMI, insulin resistance, and hypoadiponectinemia in the general population.

Keywords: Pancreatic hyperechogenicity, Metabolic syndrome, Obesity, Adiponectin, The Takahata study

Core tip: Pancreatic hyperechogenicity is related to aging. Several recent studies have reported that hepatic steatosis and increased body mass index (BMI) are predictors of a hyperechogenic pancreas. In the present study, fatty liver was also significantly associated with pancreatic hyperechogenicity. We performed additional analyses excluding participants with fatty liver in order to account for the effect of this condition. Our analyses showed that an increased BMI, higher homeostasis model assessment of insulin resistance score, and decreased adiponectin were also significantly associated with pancreatic hyperechogenicity.