The state of the pancreas in obese adults and children

The objective. Study of the incidence of nonalcoholic fatty pancreas disease (NAFPD) in obesity, a comparative clinicalbiochemical characteristic of this pathology in children and adults.

Patients and methods. The study included 50 obese patients (25 adults and 25 children) aged 12 to 60 years (BMI ≥30 kg/m2 for adults, BMI Z-score ИМТ ≥2.0 for children), without diabetes mellitus type 2 or severe associated pathology. All patients underwent clinical-laboratory, instrumental examination including anthropometric measurements. US of the organs of the abdominal cavity was performed on the Logiq S6 system (General Electric Company). CT of the abdominal cavity (n = 14) was performed on the Optima CT660 system (General Electric Company).

Results. According to US findings, secondary changes of the pancreas were recorded in 46 obese patients (92%), with equal frequency in adults and children. No relation has been found between pancreatic steatosis and changes of enzymes characteristic of lesion of the pancreas (GGT, ALP, total and pancreatic amylase, lipase). Pancreatic steatosis was ageassociated: in the group of patients older than 18 years it was found significantly more often according to computed tomography (CT). CT signs of pancreatic steatosis (lipomatosis) are associated with moderate and severe steatosis at US of the pancreas. The median pancreas density in the group of adults was lower than in children: 29.5 [20.0; 32.5] HU vs 47.0 [43.0; 54.0] HU, p = 0.017. Density of pancreatic parenchyma correlated significantly with patients’ age (R = –0.731) and lipid profile parameters: total cholesterol levels (R = –0.680), LDL cholesterol (R = –0.694), triglycerides (R = –0.614), non-HDL cholesterol (R = –0.698). In diagnosed mild pancreatic steatosis according to US findings no changes of the density of the pancreatic were found by CT.

Conclusion: Obesity is an important pathogenetic factor in the development of NAFPD. The results of the study will permit to enhance the quality of diagnosing and treatment of pancreatic pathologies associated with obesity in adults and children.

Key words: pancreas, obesity, steatosis, diagnosis, ultrasound examination.

For citation: Pavlovskaya E.V., Starodubova A.V., Strokova T.V., Zeygarnik M.V., Kosyura S.D., Surkov A.G., Bagaeva M.E., Kaganov B.S. The state of the pancreas in obese adults and children. Vopr. dietol. (Nutrition). 2016; 6(4): 10–16. (In Russian).
DOI: 10.20953/2224-5448-2016-4-10-16