Improvement of Pancreatic Steatosis and Indices of Insulin Resistance After Metabolic Surgery

Overview

Journal Front Med (Lausanne)

Specialty General Medicine

Date 2022 Jun 23

PMID 35733870

Authors

Ahmed Abdallah Salman

Mohamed AbdAlla Salman

Mostafa Said

Mohammad El Sherbiny

Hesham Elkassar

Mohamed Badr Hassan

Ahmed Marwan

Mohamed Abdelkader Morad

Omar Ashoush

Safa Labib

Mohamed H Aon

Abeer Awad

Mohamed Sayed

Ahmed E Taha

Ahmed Moustafa

Hossam El-Din Shaaban

Amir Khater

Ahmed Elewa

Adel M Khalaf

Ahmed A Mostafa

Mohamed Matter

Ahmed Youssef

Affiliations

Soon will be listed here.

Abstract

Purpose: Obesity is associated with fat accumulation in ectopic sites such as the pancreas, the so-called pancreatic steatosis (PS). Bariatric surgery has been shown to be associated with reducing pancreatic fat. This study investigated the effect of laparoscopic sleeve gastrectomy (LSG) on pancreatic volume and its fat content and glucose homeostasis.

Methods: The study enrolled 54 patients subjected to LSG. Metabolic variables and pancreatic exocrine function were assessed immediately before surgery and 12 months after. MRI of the abdomen was performed to measure pancreatic fat content and its total volume and visceral adipose tissue (VAT).

Results: Surgery resulted in a significant reduction in body weight and BMI. HbA1c, fasting insulin, C-peptide levels, HOMA-IR, and Hs-CRP levels decreased significantly. Surgery resulted in significant improvement in lipid profile except for HDL-cholesterol and liver function tests. Total VAT volume decreased significantly. Total pancreas volume decreased by a mean of 9.0 cm (95% CI: 6.6-11.3). The median change of pancreatic fat was -26.1% (range: -55.6 to 58.3%). Pancreatic lipase decreased significantly ( < 0.001). There was a positive correlation between the percentage of total weight loss and decrease in pancreatic fat volume ( = 0.295, = 0.030).

Conclusion: Weight loss after LSG is associated with a reduction of total VAT volume, total pancreatic volume, and pancreatic fat content. These changes are associated with improved glucose homeostasis, reduced systemic inflammation, and decreased pancreatic lipase secretion.

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