STUDYING THE ASSOCIATION BETWEEN NON-ALCOHOLIC FATTY LIVER DISEASE AND NON-ALCOHOLIC FATTY PANCREAS DISEASE USING TRANSABDOMINAL ULTRASOUND AND ENDOSCOPIC ULTRASOUND

Ahmed Sameh Hamed El-Esawy, Magdy AbdAl-Kareem Al-Dahshan, Mohammed Salah Ali, Mohamed Farouk Agag
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Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is characterized by hepatic triglyceride accumulation not due to alcohol consumption (<20 g ethanol per day), resulting in steatosis and hepatic inflammation. NAFLD is currently the most common liver disorder, particularly in Western countries. Worldwide, the prevalence of NAFLD is about 25%. Nonalcoholic fatty pancreas disease (NAFPD) is an excessive lipid accumulation in the pancreas in the absence of significant alcohol intake. Endoscopic ultrasound (EUS) can provide detailed images of the entire pancreas. The use of high-frequency US waves and the ability to simultaneously image adjacent organs like the liver and spleen in real-time. Objective: To determine the possible association between non-alcoholic fatty pancreatic disease (NAFPD) and non-alcoholic fatty liver disease (NAFLD). Patients and methods: This study was conducted on 100 subjects divided into two equal groups: Group I Included individuals with sonographically proven NAFLD, and Group II (control group): Included healthy individuals with no sonographic evidence of NAFLD. All cases were selected from Internal Medicine Department at Al-Hussein Hospital, Al-Azhar University, during the period from April 2019 to April 2020. Results: Based on the severity of fatty pancrease, moderate and severe fatty pancrease was significantly associated with older age with p value 0.0001. Fasting-blood-sugar (FBS), erythrocyte sedimentation rate (ESR), and aspartate-aminotransferase (AST) significantly higher in moderate and severe fatty pancreases too with p value 0.0001, 0.001 and 0.0001 respectively. Serum albumin level was the lowest in severe fatty pancreases with p value 0.001. In addition, low-density lipoprotein (LDL), TG and cholesterol was significantly higher in severe fatty pancreases with p value 0.0001, 0.0001 and 0.0001 respectively. High-density lipoprotein (HDL) was the highest in absent fatty pancreases with p value 0.0001. Patient with severe fatty pancrease was only present in fatty liver group with 24%. Conclusion: Degree of pancreatic steatosis was significantly related to old age, high erythrocyte sedimentation rate, low albumin level, high cholesterol, high triglycerides, and low high-density lipoprotein. Pancreatic steatosis was significantly correlated to presence of fatty liver.
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利用经腹超声波和内窥镜超声波研究非酒精性脂肪肝与非酒精性脂肪胰腺疾病之间的关联
背景:非酒精性脂肪性肝病(NAFLD)的特点是肝脏甘油三酯积聚,而不是因为饮酒(每天摄入乙醇小于 20 克),从而导致脂肪变性和肝脏炎症。非酒精性脂肪肝是目前最常见的肝脏疾病,尤其是在西方国家。在全球范围内,非酒精性脂肪肝的发病率约为 25%。非酒精性脂肪性胰腺疾病(NAFPD)是指在没有大量酒精摄入的情况下,胰腺中脂质过度积聚。内窥镜超声(EUS)可提供整个胰腺的详细图像。高频 US 波的使用以及同时对肝脏和脾脏等邻近器官进行实时成像的能力。目的确定非酒精性脂肪性胰腺疾病(NAFPD)与非酒精性脂肪性肝病(NAFLD)之间可能存在的关联。患者和方法:研究对象为 100 名受试者,分为两组:第一组包括经声像图证实患有非酒精性脂肪肝的人,第二组(对照组):包括没有非酒精性脂肪肝声像图证据的健康人。所有病例均选自爱资哈尔大学侯赛因医院内科,时间为 2019 年 4 月至 2020 年 4 月。研究结果根据脂肪胰腺的严重程度,中度和重度脂肪胰腺与年龄明显相关,P值为0.0001。中度和重度脂肪胰腺的空腹血糖(FBS)、红细胞沉降率(ESR)和天冬氨酸氨基转移酶(AST)也明显升高,P 值分别为 0.0001、0.001 和 0.0001。重度脂肪胰腺的血清白蛋白水平最低,P 值为 0.001。此外,低密度脂蛋白(LDL)、总胆固醇(TG)和胆固醇在重度脂肪性胰腺中明显升高,p 值分别为 0.0001、0.0001 和 0.0001。无脂肪胰腺患者的高密度脂蛋白(HDL)最高,P 值为 0.0001。重度脂肪胰腺患者仅出现在脂肪肝组,占 24%。结论胰腺脂肪变性程度与高龄、高红细胞沉降率、低白蛋白水平、高胆固醇、高甘油三酯和低高密度脂蛋白明显相关。胰腺脂肪变性与脂肪肝的存在明显相关。
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