| Part 1Analysis of risk factors for fatty pancreas-A cross-sectional study based on a natural populationObjective:This study was based on a large natural population cohort in Yangzhou to analyze the risk factors for fatty pancreas.Methods:Clinical data were collected from January 2021 to December 2021 from the population undergoing health check-ups at the Health Management Center of the Affiliated Hospital of Yangzhou University.Subjects were divided into fatty pancreas group and non-fatty pancreas group by abdominal ultrasound,and the general clinical data(age,gender,body mass index,abdominal circumference),laboratory indices(lipid quadruple,liver and kidney function,glycated hemoglobin),and concomitant diseases(hypertension,diabetes,fatty liver,thyroid nodules,gallbladder stones,gallbladder polyps),and previous surgical history(thyroidectomy,cholecystectomy)of the two groups were compared whether there was a statistical difference.Based on the results of the univariate analysis,indicators with a P value < 0.05 were included in a dichotomous logistic regression model to further establish independent risk factors for fatty pancreas.Results:1.Analysis of general baseline information of the two groups: A total of 11,167 subjects were included in this study.Of these,890 were in the fatty pancreas group and 10,277 in the non-fatty pancreas group.There were 664(74.6%)males and 226(25.4%)females in the fatty pancreas group.The mean age,body mass index and abdominal circumference were all higher in the fatty pancreas group than in the non-fatty pancreas group,with statistical differences between the two(P<0.05).The difference in the proportion of smoking and the proportion of drinking history between the two groups was statistically significant(P<0.05).2.Analysis of metabolic disorders in both groups: general obesity(29%vs 12.6%,P<0.001),central obesity(66.7vs39.7%,P<0.001),hypertension(42.3%vs 28.2%,P<0.001),diabetes mellitus(9.5%vs6.9%,P=0.005),hyperuricemia(1.5%vs 0.8%,P=0.025),fatty liver(70.1%vs45.7%,P<0.001),hypertriglyceridemia(28.5%vs 21.8%,P<0.001),hypercholesterolemia(13%vs10.5%,P=0.021),mixed hyperlipidemia(6.0%vs3.9%,P=0.003),low hyper density lipoproteinemia(26.2%vs20%,P<0.001)were significantly more prevalent than in the non-fat pancreas group.3.Laboratory parameters including lipid quadruple(triacylglycerol,total cholesterol,HDL),liver function(alanine aminotransferase,aspartate aminotransferase,glutamyl peptidase,fasting glucose),renal function(blood uric acid)and glycated hemoglobin were statistically significant(P<0.05)when compared between the two groups.Creatinine and low-density lipoprotein were not statistically different.4.Other diseases and history of previous surgery: In addition,the study found a higher proportion of thyroid nodules,previous thyroidectomy and history of cholecystectomy surgery in the fatty pancreas group than in the non-fatty pancreas group(P<0.05).There was no statistical difference in the prevalence of gallbladder.5.Binary logistic regression analysis showed that age(40-50 years OR=1.858,P<0.001;≥50 years OR=3.045,P<0.001),female(OR=1.322,P=0.001),general o besity(OR=1.757,P<0.001),abdominal obesity(OR=2.035,P< 0.001),fatty liver(mild OR=1.817,P<0.001;moderate OR=2.036,P<0.001;severe OR=5.068,P=0.010),alcohol consumption(OR=1.282,P=0.012),and thyroid nodules(OR=1.353,P=0.010)were independent risk factors for fatty pancreas.Conclusion:Women,increasing age,alcohol consumption,general obesity,central obesity,fatty liver,and thyroid nodules are independently associated with fatty pancreas.Abdominal obesity is associated with a higher risk than general obesity.The risk of developing a fatty pancreas was 1.817,2.036 and 5.068 times higher in the mild,moderate and severe fatty liver groups respectively than in the no fatty liver group.The risk of fatty pancreas was 1.858 and 3.045 times higher in the age group 40-50 years and ≥50 years,respectively, than in the group ≤40 years.Part 2Analysis of the correlation between fatty pancreas and subclinical atherosclerosisObjective:This study was based on a large natural population cohort in Yangzhou to investigate the association between fatty pancreas and subclinical atherosclerosis.Methods:Clinical data were collected from January 2021 to December 2021 from the population undergoing health check-ups at the Health Management Center of the Affiliated Hospital of Yangzhou University.Carotid vascular ultrasound divided the subjects into carotid plaque group and non-carotid plaque group,and compared whether there were statistical differences in general clinical data(age,sex,body mass index,abdominal circumference),laboratory indices(lipid quadruple,liver and kidney function,glycated hemoglobin),and concomitant diseases(hypertension,diabetes,fatty liver,fatty pancreas)between the two groups.Based on the results of the univariate analysis,indicators with P<0.05 were included in a dichotomous logistic regression model to further establish independent risk factors for carotid plaque.Results:1.Analysis of baseline data of the study population: A total of 4336 cases in the carotid plaque group and 6831 cases in the non-carotid plaque were included in the study.The proportion of males with carotid plaque and non-carotid plaque was 80.9%(3506/4336)and 75.1%(5127/1704),respectively.The mean age was 63±12 years in the carotid plaque group and 50±12 years in the non-carotid plaque group,with a significant difference compared to the two groups(P<0.001).The history of smoking and alcohol consumption was significantly higher in the carotid plaque group than in the non-carotid plaque group(P<0.001).Metabolic diseases including hypertension,diabetes mellitus,and fatty pancreas were significantly higher in the carotid plaque group than in the non-carotid plaque group(all P values < 0.001),and central obesity,hypercholesterolemia,low HDL-cholesterol,hyperuricemia,and metabolic syndrome were significantly higher than in the non-carotid plaque group,(all P values < 0.05).In contrast,hypertriglyceridemia and mixed hyperlipidemia were not statistically different in the two groups(P>0.05).The mean values of FPG,Hb A1 c,AST and SCR were higher in the carotid plaque group than in the non-carotid plaque group(P<0.05).There was no statistical difference in the four lipid categories(TG,CHO,HDL-C,LDL-C),liver function(AST,GGT)and renal function(SUA)between the two groups(P>0.05).2.Binary logistic regression model analysis of carotid plaque: results showe d that men(OR=1.152,P=0.04),age(OR=1.100,P<0.001),history of smoking(OR=1.387,P<0.001),history of alcohol consumption(OR=1.345,P<0.001),hypertension(OR=1.177,P=0.014),diabetes mellitus(OR=1.581,P<0.001),fatty pancreas(0R=1.232,P=0.013),hypercholesterolemia(OR=1.231,P=0.005),and low HDL athero ma(OR=1.166,P=0.010)were independent risk factors for carotid plaque.3.Subgroup analysis:(i)Hypertensive and non-hypertensive groups: univariate analysis showed that the fatty pancreas without hypertension group was independently associated with carotid plaque,(OR=1.4999,P<0.001)and the fatty pancreas with hypertension group showed no statistical difference(P>0.05).After correcting for confounders,binary logistic regression showed no association between adipose pancreas and carotid plaque in either the Q1 or Q2 model in the group with adipose pancreas combined with hypertension(P>0.05).(P>0.05).(ii)Diabetic and non-diabetic groups: univariate analysis showed that fatty pancreas without diabetes was independently associated with carotid plaque(OR=1.499,P<0.001),while fatty pancreas with diabetes was not associated with carotid plaque(P>0.05).Binary logistic regression analysis showed no association with carotid plaque in the fatty pancreas combined with diabetes group,regardless of the Q1 and Q2 models.In the group without diabetes mellitus,the Q1 model showed that adipose pancreas was still independently associated with carotid plaque(OR=1.210,P=0.025),while the Q2 model showed no association between adipose pancreas and carotid plaque(P>0.05).(iii)Hypercholesterolemia versus non-hypercholesterolemia: univariate results showed no correlation between adipose pancreas combined with hypercholesterolemia and carotid plaque,and the adipose pancreas uncomplicated with hypercholesterolemia group was independently associated with carotid plaque(OR=1.488,P<0.001).The binary logistic regression model showed no association with carotid plaque in the fatty pancreas combined with hypercholesterolemia group in either the Q1 or Q2 model(P>0.05),and no association with carotid plaque in the fatty pancreas uncomplicated with hypercholesterolemia group in the Q1 model(OR=1.224,P=0.017),and no association with carotid plaque in the Q2 model(P>0.05).(iv)Low HDL and non-HDL: fatty pancreas was independently associated with carotid plaque regardless of whether it was combined with low HDL group(P<0.05).Binary logistic regression models showed that correcting for age and sex confounders,both groups were still independently associated with carotid plaque(P<0.05).After correcting for confounders of sex,age,hypertension,diabetes,fatty liver,general obesity,history of alcohol consumption,hypertriglyceridemia,ALT,CHO,LDL-C and GGT,adipose pancreas combined with low HDL-cholesterol was still independently associated with carotid plaque(OR=1.473,95% CI:1.080-1.990,P=0.013),whereas adipose pancreas without low HDL-cholesterol was independently associated with carotid plaque(OR=1.473,95% CI:1.080-1.990,P=0.013).There was no association with carotid plaque in the fatty pancreas uncomplicated low-density lipoproteinemia group(P>0.05).Conclusion:Male,age,history of smoking,history of alcohol consumption,hypertension,diabetes mellitus,fatty pancreas,hypercholesterolemia,and low-density lipoproteinemia were independent risk factors for carotid plaque.Patients with fatty pancreas combined with low-density lipoproteinemia had an increased risk of developing carotid plaque compared with those without combined low-density lipoproteinemia. |
PDF Full Text Request