Severity of hyperechoic pancreas on ultrasonography as a risk factor for glycemic progression
Jiyun Oh1 , Hyun Jeong Park1 , Eun Sun Lee1 , Sung Bin Park1 , Byung Ihn Choi1 , Soohyun Ahn2
1Chung-Ang University Hospital , Seoul, Korea
2Ajou University , Suwon , Korea
Corresponding Author: Hyun Jeong Park ,Tel: 82262992767, Fax: 82262992767, Email:
Received: August 10, 2020;  Accepted: January 16, 2021.  Published online: January 16, 2021.
To evaluate the association between the severity of hyperechoic pancreas (HP) on ultrasonography (US) and glycemic progression
Total 1,386 participants who had undergone abdominal US as part of health examination between December 2008 and May 2014 were included in this retrospective study. We classified pancreatic echogenicity into a 4 point scale, and compared it by dividing it into two criteria: FP1 (fatty pancreas) criterion (normal vs. ≥ mild HP) and FP2 criterion (normal/mild HP vs. ≥ moderate HP). According to the relationship with NAFLD, participants were subdivided into 4 groups; 1.non-NAFLD (nonalcoholic fatty liver disease)/non-HP, 2.isolated NAFLD, 3.isolated HP, and 4.HP with NAFLD. Glycemic progression was defined as progression from normoglycemia to prediabetes or diabetes or progression from prediabetes to diabetes
During the follow-up (median, 5.9 years), 262 of 1,386 participants developed glycemic progression. Using FP2, the probability of glycemic progression across the four subgroups showed cumulative aggravation for NAFLD and HP (all p<0.05). Isolated HP showed a higher probability of glycemic progression than isolated NAFLD in FP2 (p<0.001). The highest probability of glycemic progression was observed in subgroup with both NAFLD and HP (p<0.001). The hazard ratio for glycemic progression with increasing severity of HP increased.
Increasing severity of HP on US is significantly correlated with glycemic progression. Moreover, isolated HP of more than moderate severity is a relevant factor for predicting glycemic progression independent of NAFLD.
Keywords: Ultrasonography; Hyperechoic pancreas; Fatty pancreas; Diabetes ; Nonalcoholic fatty liver disease
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