Hyperechoic pancreas on ultrasonography: emphasis on its severity and clinical implications
Hyunji Oh1 , Hyun Jeong Park1 , Jiyun Oh1 , Eun Sun Lee1 , Min Jae Cha1, Sung Bin Park1 , Soohyun Ahn2
1Chung-Ang University Hospital , Seoul, Korea
2Ajou university , Suwon, Korea
Corresponding Author: Hyun Jeong Park ,Tel: 82262992767, Fax: 82262992767, Email: seolly1024@gmail.com
Received: May 3, 2021;  Accepted: September 30, 2021.  Published online: September 30, 2021.
To identify the risk factors of hyperechoic pancreas (HP) on ultrasonography (US) according to the severity of hyperechoic pancreas (HP).
Between December 2008 and February 2014, a total of 1459 subjects who underwent abdominal US as part of health examination were retrospectively included. Two radiologists assessed and categorized the severity of HP into normal, mild, moderate, and severe. Based on this, we allocated the subjects to two group according to the criteria; FP1 (fatty pancreas 1, normal vs. ≥ mild HP) and FP2 (normal and mild HP vs. ≥ moderate HP). Clinico-metabolic parameters of the subjects with normoglycemia and prediabetes/diabetes were compared. Logistic regression analysis was used to evaluate the associations between HP, non-alcoholic fatty liver disease (NAFLD) and diabetes/prediabetes with adjustment for clinico-metabolic parameters.
Of the 1459 subjects, 71.2% and 40.4% showed HP and NAFLD on US, respectively. Normoglycemia and prediabetes/diabetes were 74.3% and 25.7%, respectively. Univariable analysis revealed that all the clinico-metabolic parameters were significantly associated with HP (all p < 0.05). In adjusted multivariable analysis, prediabetes/diabetes, NAFLD, age, and body mass index were significantly associated with HP in the FP1 and FP2 criteria. The independent factor with the strongest association with HP was NAFLD in the FP1 (OR=7.93, p < 0.001), and prediabetes/diabetes in the FP2 (OR=6.96, p < 0.001).
NAFLD and prediabetes/diabetes are associated with HP diagnosed with US. Obviously increased HP is a better predictor of prediabetes/diabetes. Therefore, the evaluation of the severity of HP may be useful in clinical practice.
Keywords: Ultrasonography; Hyperechoic pancreas; Fatty pancreas; Diabetes; Nonalcoholic fatty liver disease
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