With the increasing use of imaging modalities such as ultrasonography, computed tomography, and magnetic resonance imaging, incidental findings of pancreatic abnormalities, including pancreatic cysts and fatty pancreas (FP), have become more common. FP, also referred to as pancreatic steatosis, intra-pancreatic fat deposition, or fatty pancreas disease, is characterized by the accumulation of fat in the pancreas. Although FP has been associated with metabolic syndromes such as obesity and diabetes, its clinical significance remains unclear. Recent evidence suggests that FP may play a role in pancreatic carcinogenesis. Metabolic disorders, including obesity, insulin resistance, and diabetes, have been implicated in the development of FP. Additionally, FP has been linked to an increased risk of pancreatic ductal adenocarcinoma (PDAC), possibly due to chronic inflammation, lipotoxicity, and an altered pancreatic microenvironment. While early detection of PDAC remains challenging, surveillance strategies for high-risk individuals, such as those with pancreatic cysts, new-onset diabetes, or a genetic predisposition, may be crucial. In this context, FP may be incorporated into this surveillance of high-risk individuals. Some pharmacological interventions, including glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose cotransporter-2 (SGLT2) inhibitors, have shown potential in reducing pancreatic fat accumulation, although further studies are needed to confirm their efficacy.
随着超声、计算机断层扫描及磁共振成像等影像学检查手段的日益普及，胰腺异常（包括胰腺囊肿和脂肪胰）的偶发性发现愈发常见。脂肪胰，亦称胰腺脂肪变性、胰腺内脂肪沉积或脂肪胰疾病，其特征为胰腺内脂肪的异常积聚。尽管脂肪胰与肥胖、糖尿病等代谢综合征存在关联，但其临床意义尚未明确。最新证据表明，脂肪胰可能在胰腺癌发生过程中发挥作用。肥胖、胰岛素抵抗及糖尿病等代谢紊乱因素与脂肪胰的发生发展密切相关。此外，脂肪胰与胰腺导管腺癌风险升高存在关联，其潜在机制可能涉及慢性炎症、脂毒性作用及胰腺微环境改变。虽然胰腺导管腺癌的早期诊断仍面临挑战，但对高危人群（如胰腺囊肿患者、新发糖尿病患者或具有遗传易感性的个体）进行监测至关重要。在此背景下，可将脂肪胰纳入高危人群的监测体系。部分药物干预措施，如胰高血糖素样肽-1受体激动剂和钠-葡萄糖协同转运蛋白-2抑制剂，已显示出减少胰腺脂肪积聚的潜力，但其疗效尚需进一步研究验证。
Fatty Pancreas: Its Potential as a Risk Factor for Pancreatic Cancer and Clinical Implications
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