Ultrasonographic Quantitative Analysis of Fatty Pancreas in Obese Children: Its Correlation with Metabolic Syndrome and Homeostasis Model Assessment of Insulin Resistance - 30/11/17

Doi : 10.1016/j.jpeds.2017.10.007

Doo Ri Kim, MD ¹, Mu Sook Lee, MD ^1,^* , Jeong Sub Lee, MD ¹, Guk Myung Choi, MD ¹, Ki Soo Kang, MD ²
¹ Department of Radiology of Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Republic of Korea
² Department of Pediatrics of Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Republic of Korea

^*Reprint requests: Mu Sook Lee, MD, Department of Radiology of Jeju National University Hospital, Jeju National University, School of Medicine, Aran 13gil, 15 (AraIl-dong), Jeju-si, Jeju Special Self-Governing 690-767, Republic of Korea.Department of Radiology of Jeju National University HospitalJeju National UniversitySchool of MedicineAran 13gil15 (AraIl-dong)Jeju-siJeju Special Self-Governing690-767Republic of Korea

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Abstract

Objectives

To evaluate pancreatic echogenicity on transabdominal ultrasonography and the correlation of fatty pancreas with metabolic syndrome (MetS), as well as insulin resistance (homeostasis model assessment of insulin resistance [HOMA-IR]).

Study design

This retrospective study included 135 obese children and adolescents who underwent transabdominal ultrasonography from January 2015 to December 2015. Fatty pancreas was quantitatively analyzed using the pancreato-perihepatic fat index (PPHFI). The correlation between the PPHFI and HOMA-IR was analyzed, and multivariate logistic regression analysis was used to determine factors that were independently correlated with MetS. Receiver operating characteristic curve analysis was performed to determine the best cut-off value of the PPHFI for diagnosing MetS.

Results

The PPHFI and the HOMA-IR value were significantly higher in subjects with MetS than in those without MetS (P < .0001). The PPHFI also showed an association with the HOMA-IR value (r = 0.70; P < .0001). The PPHFI was an independent factor for diagnosing MetS (OR 4.36; P = .032). The best cut-off value for the PPHFI for a diagnosis of MetS was 2.34 with a sensitivity of 0.96 and specificity 0.70.

Conclusions

These results suggest that an increased PPHFI is significantly correlated with MetS and insulin resistance, and that the PPHFI may be a useful indicator for diagnosing MetS in obese children and adolescents. The impact of the presence of fatty pancreas in obese children and adolescents must be evaluated

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Keywords : obesity, fatty pancreas, insulin resistance

Abbreviations : ALP, ALT, AST, BMI, CT, HbA1C, HDL, HOMA-IR, LDL, MetS, MRI, PPHFI, ROI, TG, WC