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Non-Alcoholic Fatty Pancreas Disease and its Associated Factors in Type 2 Diabetes Mellitus Patients

Juliyanti Fu, C Rinaldi A Lesmana, Imam Subekti, Irsan Hasan, Andri Sanityoso, Kuntjoro Harimurti, Rino A Gani

Context Understanding of non-alcoholic fatty pancreas disease and its clinical impact needs to be continuously improved as non-alcoholic fatty pancreas disease might allegedly develop into chronic pancreatitis and further leads to pancreatic cancer. Non-alcoholic fatty pancreas disease is strongly associated with type 2 diabetes mellitus and long-term type 2 diabetes mellitus is associated with a 2.0-fold increase in the risk of pancreatic cancer. The proportion of non-alcoholic fatty pancreas disease and its associated factors in type 2 diabetes mellitus population has not been well investigated. Objective To investigate the proportion of non-alcoholic fatty pancreas disease and its associated factors in type 2 diabetes mellitus population. Methods This was a cross-sectional study in adult type 2 diabetes mellitus patients who visited Diabetes Clinic, Cipto Mangunkusumo Hospital. Information about age, sex, duration of diabetes, comorbidities, medication, waist circumference, lipid profile and HbA1C were collected. Abdominal ultrasonography was performed on each subject to diagnose non-alcoholic fatty pancreas disease and non-alcoholic fatty liver disease. Association of non-alcoholic fatty pancreas disease with age, sex, duration of diabetes, hypertension, non-alcoholic fatty liver disease, triglyceride and HbA1C were examined. Study Results From total of 171 type 2 diabetes mellitus patients in this study, the proportion of non-alcoholic fatty pancreas disease was 48.5% (95%CI=41.2 to 55.9%). Univariate analysis showed significant differences between non-alcoholic fatty pancreas disease (NAFPD) and non-NAFPD group regarding proportion of non-alcoholic fatty liver disease (PR=1.96; 95%CI=1.41-2.74; p<0.001) and hypertriglyceridemia (PR=1.38; 95%CI=1.02-1.86; p=0.042). On multivariate analysis older age (OR=2.15; 95%CI=1.10-4.23), non-alcoholic fatty liver disease (OR=3.65; 95%CI=1.90-6.99), and hypertriglyceridemia (OR=2.03; 95%CI=1.02-4.05) showed significant association with non-alcoholic fatty pancreas disease. Conclusion The proportion of non-alcoholic fatty pancreas disease in type 2 diabetes mellitus population is 48.5%. Older age, non-alcoholic fatty liver disease and hypertriglyceridemia were associated factors of non-alcoholic fatty pancreas disease in type 2 diabetes mellitus patient.