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      Esteatosis pancreática, ¿hallazgo casual o factor de riesgo? Translated title: Pancreatic steatosis, casual finding or risk factor?

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          Abstract

          Resumen: Se presenta el caso de un adolescente con esteatosis pancreática, en contexto de obesidad y en concurrencia con una esteatosis hepática. Dicho hallazgo es poco común en la edad pediátrica. En este rango de edad también se asocia a algunos trastornos genéticos, como la fibrosis quística, el síndrome de Swachmann-Diamond y el síndrome de CLOVES. Se ha demostrado que los pacientes con un páncreas graso tienen mayor riesgo de desarrollar síndrome metabólico, diabetes tipo II, pancreatitis crónica y cáncer de páncreas, motivo por el cual es importante su seguimiento periódico.

          Translated abstract

          Abstract: A case of a teenager with pancreatic steatosis is exposed, in the context of obesity and in the same time of a hepatic steatosis. This is an uncommon finding in the pediatric population. In pediatric age it is associated with some genetic disorders, like cystic fibrosis, Swachmann-Diamond syndrome and CLOVES syndrome. It has been proved that patients with fatty pancreas have an increased risk of developing metabolic syndrome, diabetes mellitus II, chronic pancreatitis and pancreatic cancer, reason why it is crucial a periodic check out.

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          Most cited references9

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          Clinical implications of fatty pancreas: correlations between fatty pancreas and metabolic syndrome.

          To investigate the clinical implications of lipid deposition in the pancreas (fatty pancreas). The subjects of this study were 293 patients who had undergone abdominal computed tomography (CT) and sonography. Fatty pancreas was diagnosed by sonographic findings and subdivided into mild, moderate, and severe fatty pancreas groups comparing to the retroperitoneal fat echogenicity. Fatty pancreas was associated with higher levels for visceral fat, waist circumference, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol, triglyceride, high density lipoprotein, free fatty acid, gamma-GTP, insulin, and the homeostasis model assessment of insulin resistance (HOMA-IR) than the control group (P < 0.05). HOMA-IR, visceral fat, triglyceride, and ALT also tended to increase with the degree of fat deposition in the pancreas on sonography. In a multivariate logistic regression analysis, HOMA-IR, visceral fat, and ALT level were independently related to fatty pancreas after adjustment for age, body mass index, and lipid profile. The incidence of metabolic syndrome in the fatty pancreas group was significantly higher than in the control group, and the numbers of metabolic syndrome parameters were significantly higher in the fatty pancreas group (P < 0.05). Sonographic fatty pancrease showed higher insulin resistance, visceral fat area, triglyceride, and ALT levels than normal pancreases. Fatty pancreas also showed a strong correlation with metabolic syndrome.
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            Nonalcoholic Fatty Pancreas Disease: Clinical Consequences

            Metabolic syndrome and its components such as obesity, hypertriglyceridemia, type-2 diabetes mellitus (DM-T2), and arterial hypertension are unequivocally serious problems for every society. This is especially true in economically developed countries where the imbalance in lifestyle between caloric intake and caloric output still gets greater and greater. This fact is not only a concern for the adult population but for children as well. However, metabolic syndrome does not only affect society and health in regards to cardiovascular diseases, it significantly concerns gastroenterology where it is classified as nonalcoholic fatty pancreas disease (NAFPD). The data gained from several trials show that the prevalence of NAFDP is 33% (95% CI 24–41%). When it comes to the diagnostic procedures concerning the presence of pancreatic fat, a whole spectrum of suitable methods are recommended. Probably, the most exact method is the use of magnetic resonance imaging. However, for common clinical practice, the abdominal sonographic examination based on the comparison of the pancreatic parenchymatous echogenity versus renal or hepatic echogenity is used. The clinical consequences of pancreatic steatosis and steatopancreatitis are significant. These diseases are connected with DM-T2 and insulin resistance. In recent years, changes of exocrine pancreatic function, particularly its decrease, have also been described. It is known that there is a close correlation between NAFPD and nonalcoholic hepatic steatosis and also with the increased thickness of aortic intima-media. There is also an important relationship between NAFPD and pancreatic carcinoma. Pancreatic steatosis, and especially its NAFPD form, is a serious state which can be treatable by the possible effective management of metabolic syndrome parameters, including obesity.
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              Pancreatic fat and β-cell function in overweight/obese children with nonalcoholic fatty liver disease.

              To analyze the associations of pancreatic fat with other fat depots and β-cell function in pediatric nonalcoholic fatty liver disease (NAFLD).
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                Author and article information

                Journal
                pap
                Pediatría Atención Primaria
                Rev Pediatr Aten Primaria
                Asociación Española de Pediatría de Atención Primaria (Madrid, Madrid, Spain )
                1139-7632
                June 2020
                : 22
                : 86
                : 181-183
                Affiliations
                [1] Madrid orgnameHospital Universitario 12 de Octubre orgdiv1Servicio de Pediatría orgdiv2Sección de Gastroenterología, Hepatología y Nutrición Pediátrica España
                [2] Madrid orgnameHospital Universitario 12 de Octubre orgdiv1Servicio de Radiodiagnóstico orgdiv2Sección de Radiología Infantil España
                Article
                S1139-76322020000300012 S1139-7632(20)02208600012
                5ab4464c-96f4-4f48-bd55-fe044cf1ceff

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 9, Pages: 3
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                SciELO Spain

                Categories
                Casos clínicos en Digestivo

                Esteatosis,Obesidad,Páncreas,Obesity,Pancreas,Steatosis
                Esteatosis, Obesidad, Páncreas, Obesity, Pancreas, Steatosis

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