Excess Liver Fat in Type 2 Diabetes Stratified by Intrapancreatic Fat Deposition: A Meta-Analysis of Dual-Organ MRI Studies.
Hyun Hee Sul, Saeed Ahmad, Pojsakorn Danpanichkul et al.
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In 30 seconds
This meta-analysis pooled dual-organ MRI studies comparing liver fat content (LFC) in people with type 2 diabetes (T2DM) and non-diabetic controls, and examined whether study-level intrapancreatic fat deposition (IPFD) related to the difference. Across 17 studies involving 2142 participants, LFC was higher in T2DM (standardised mean difference [SMD] 0.89, 95% CI 0.60-1.18). Exploratory analyses found a larger excess in studies with mean IPFD ≥ 10% than in those with IPFD < 10% (SMD 1.20 vs. 0.62; p = 0.04), but this result was not robust in leave-one-out analyses and the association was not retained after BMI adjustment.
Key findings
- Across 17 studies and 2142 participants, LFC was higher in T2DM than in controls (SMD 0.89, 95% CI 0.60-1.18).
- The LFC difference was larger in studies with mean IPFD ≥ 10% than with IPFD < 10% (SMD 1.20 vs. 0.62; p = 0.04), but was not consistent in leave-one-out analyses.
- Study-level IPFD differences were associated with LFC differences in univariable meta-regression (β = 0.383, p = 0.006), but not after BMI adjustment.
Why it matters
The findings reinforce that excess liver fat is associated with T2DM and suggest that pancreatic fat burden may track with the degree of liver fat excess. However, the IPFD relationship is exploratory and sensitive to analysis choices, and its attenuation after BMI adjustment leaves uncertainty about whether it adds information beyond body mass index.
What to keep in mind
The IPFD analyses were study-level rather than individual-level, and the subgroup result was not robust in leave-one-out analyses. The meta-regression association was not retained after BMI adjustment.