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Novel MRI estimation vs liver histology to determine fibrosis in NAFLD

The latest issue of the Alimentary Pharmacology & Therapeutics investigates the association between novel MRI-estimated pancreatic fat and liver histology-determined steatosis and fibrosis in non-alcoholic fatty liver disease.

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Ectopic fat deposition in the pancreas and its association with hepatic steatosis have not previously been examined in patients with biopsy-proven non-alcoholic fatty liver disease.

Dr Loomba and colleagues from California, USA quantified pancreatic fat using a novel magnetic resonance imaging technique.

The researchers determined whether it is associated with hepatic steatosis, and/or fibrosis in patients with non-alcoholic fatty liver disease.

The team performed a cross-sectional study including 43 adult patients with biopsy-proven non-alcoholic fatty liver disease who underwent clinical evaluation, biochemical testing, and magnetic resonance imaging.

The liver biopsy assessment was performed using the NASH-CRN histological scoring system.

Liver and pancreas fat quantification was performed using a novel, validated magnetic resonance imaging biomarker; the proton density fat fraction.

The researchers noted that the average magnetic resonance imaging-determined pancreatic fat in patients with non-alcoholic fatty liver disease was about 9%, and did not vary significantly between head, body, and tail of the pancreas.

Liver fibrosis is inversely associated with pancreatic fat content
Alimentary Pharmacology & Therapeutics

Magnetic resonance imaging-determined pancreatic fat content increased significantly with increasing histology-determined hepatic steatosis grade, by 5% in grade 1, by 8% in grade 2, and 13% in grade 3 respectively.

The team of doctors found that the pancreatic fat content was lower in patients with histology-determined liver fibrosis than in those without fibrosis.

Pancreatic fat did not correlate with age, body mass index or diabetes status.

The doctors examined that in patients with non-alcoholic fatty liver disease, increased pancreatic fat is associated with hepatic steatosis.

Dr Loomba's team concluded, "Liver fibrosis is inversely associated with pancreatic fat content."

"Further studies are needed to determine underlying mechanisms to understand if pancreatic steatosis affects progression of non-alcoholic fatty liver disease."

Aliment Pharmacol Ther 2013: 37(6): 630-639
19 February 2013

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