The association of non-alcoholic fatty pancreas disease and glycemic status


  • Pashaura Singh Department of Medicine, Government Medical College, Amritsar, Punjab, India
  • Kamalpreet Singh Department of Medicine, Government Medical College, Amritsar, Punjab, India
  • Avtar Singh Dhanju Department of Radiodiagnosis and Imaging, Government Medical College, Amritsar, Punjab, India
  • Gurinder Bir Singh Department of Medicine, Government Medical College, Amritsar, Punjab, India
  • Pranjali Batra Department of Medicine, Government Medical College, Amritsar, Punjab, India
  • Alaipreet Kaur Department of Radiodiagnosis, Dr. Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India



NAFPD, Prediabetes, Diabetes mellitus, Fatty liver


Background: Non-alcoholic fatty pancreas disease (NAFPD) is an emerging clinical entity. NAFPD is characterised by excessive fat deposition in the pancreas in the absence of alcohol consumption. Recent studies suggest that NAFPD might be associated with beta cell dysfunction, insulin resistance and inflammation which might lead to development of diabetes. NAFPD might be used as an initial indicator of glucometabolic disturbances and identify the patients with prediabetes.

Methods: This was a cross sectional study in which the glycemic status of 50 patients with NAFPD with ultrasonographic evidence of increased echogenicity of pancreas was assessed and association between glycemic variability and NAFPD was determined. The patients were also assessed for the ultrasonographic evidence of fatty liver.

Results: Pre-diabetes was noted in 32% subjects while diabetes was noted in 20% subjects. Thus, 52% patients with NAFPD had abnormal glycemic status. The 48% subjects i.e., 24 patients had normoglycemia. The presence of fatty liver was statistically significant in normoglycemia and diabetes mellitus with p=0.001 and 0.045 respectively. No statistically significant association was noted between fatty liver and prediabetes with p=0.175. No causal relationship was seen between fatty liver and glycemic variability in patients with NAFPD.

Conclusions: NAFPD is associated with impaired glycemic status. It is also seen frequently with fatty liver. Its early detection may help to identify the patients with prediabetes who may benefit from timely introduction of interventions to reduce the rising morbidity and mortality due to diabetes mellitus.


Smits MM, Van Geenen EJ. The clinical significance of pancreatic steatosis. Nature reviews Gastroenterol hepatol. 2011;8(3):169-77.

Tariq H, Nayudu S, Akella S, Glandt M, Chilimuri S. Non-alcoholic fatty pancreatic disease: a review of literature. Gastroenterol Res. 2016;9(6):87-91.

Yu TY, Wang CY. Impact of non‐alcoholic fatty pancreas disease on glucose metabolism. J Diabetes investigation. 2017;8(6):735-47.

Shimabukuro M, Zhou YT, Levi M, Unger RH. Fatty acid-induced β cell apoptosis: a link between obesity and diabetes. Proceedings National Academy of Sci. 1998;95(5):2498-502.

Heni M, Machann J, Staiger H, Schwenzer NF, Peter A, Schick F et al. Pancreatic fat is negatively associated with insulin secretion in individuals with impaired fasting glucose and/or impaired glucose tolerance: a nuclear magnetic resonance study. Diabetes/ metabol Res Rev. 2010;26(3):200-5.

McCullough AJ. Pathophysiology of nonalcoholic steatohepatitis. J Clin Gastroenterol. 2006;40:S17-29.

Van Geenen EJ, Smits MM, Schreuder TC, van der Peet DL, Bloemena E, Mulder CJ. Nonalcoholic fatty liver disease is related to nonalcoholic fatty pancreas disease. Pancreas. 2010;39(8):1185-90.

Fujii M, Ohno Y, Yamada M, Kamada Y, Miyoshi E. Impact of fatty pancreas and lifestyle on the development of subclinical chronic pancreatitis in healthy people undergoing a medical checkup. Environmental health preventive Med. 2019;24(1):1-9

Lee JS, Kim SH, Jun DW, Han JH, Jang EC, Park JY et al. Clinical implications of fatty pancreas: correlations between fatty pancreas and metabolic syndrome. World J Gastroenterol. 2009;15(15):1869-75.

Catanzaro R, Cuffari B, Italia A, Marotta F. Exploring the metabolic syndrome: Nonalcoholic fatty pancreas disease. World J Gastroenterol. 2016;22(34):7660-75.

Hu HH, Kim HW, Nayak KS, Goran MI. Comparison of fat-water MRI and single‐voxel MRS in the assessment of hepatic and pancreatic fat fractions in humans. Obesity. 2010;18(4):841-7.

Filippatos TD, Alexakis K, Mavrikaki V, Mikhailidis DP. Nonalcoholic fatty pancreas disease: role in metabolic syndrome, “prediabetes,” diabetes and atherosclerosis. Digestive Diseases and Sciences. 2021;19:1-6

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2014;37(1):S81-90.

Pinte LA, Balaban DV, Băicuş C, Jinga MA. Non-alcoholic fatty pancreas disease-practices for clinicians. Rom J Intern Med. 2019;57(3):209-19.

Tushuizen ME, Bunck MC, Pouwels PJ, Bontemps S, Van Waesberghe JH, Schindhelm RK et al. Pancreatic fat content and β-cell function in men with and without type 2 diabetes. Diabetes care. 2007;30(11):2916-21.

Alempijevic T, Dragasevic S, Zec S, Popovic D, Milosavljevic T. Non-alcoholic fatty pancreas disease. Postgraduate Med J. 2017;93(1098):226-30.

Weng S, Zhou J, Chen X, Sun Y, Mao Z, Chai K. Prevalence and factors associated with nonalcoholic fatty pancreas disease and its severity in China. Medicine (Baltimore). 2018;97(26):e11293.

Hung CS, Tseng PH, Tu CH, Chen CC, Liao WC, Lee YC et al. Increased pancreatic echogenicity with US: relationship to glycemic progression and incident diabetes. Radiology. 2018;287(3):853-63.

Ou HY, Wang CY, Yang YC, Chen MF, Chang CJ. The association between nonalcoholic fatty pancreas disease and diabetes. PloS one. 2013;8(5):e62561.

Ulasoglu C, Tekin ZN, Akan K, Yavuz A. Does Nonalcoholic Pancreatic Steatosis Always Correlate with Nonalcoholic Fatty Liver Disease? Clin Exp Gastroenterol. 2021;14:269-75.

Wu WC, Wang CY. Association between non-alcoholic fatty pancreatic disease (NAFPD) and the metabolic syndrome: case–control retrospective study. Cardiovascular Diabetol. 2013;12(1):1-6.

Kühn JP, Berthold F, Mayerle J, Völzke H, Reeder SB, Rathmann W et al. Pancreatic steatosis demonstrated at MR imaging in the general population: clinical relevance. Radiology. 2015;276(1):129-36.






Original Research Articles