J Korean Soc Radiol.  2019 Nov;80(6):1190-1202. 10.3348/jksr.2019.80.6.1190.

Predictive Performance of Ultrasound-Determined Non-Alcoholic Fatty Pancreas Disease Severity for Intermediate and High Risk of Coronary Heart Disease

• An Y
• Yun SJ
• Yang IH
• Kim DH
• Yang DM

• KMID: 2464916
• DOI: http://doi.org/10.3348/jksr.2019.80.6.1190

Abstract

PURPOSE
To evaluate non-alcoholic fatty pancreas disease severity on ultrasound (US-determined NAFPD) as a risk factor for coronary heart disease (CHD) and to evaluate its predictive value for intermediate/high CHD risk compared with US-determined non-alcoholic fatty liver disease (US-determined NAFLD) severity.
MATERIALS AND METHODS
A retrospective analysis of 544 young adults, aged 18-40 years, was performed. NAFPD and NAFLD were classified as absent, mild, moderate, and severe. CHD risk was calculated using the Framingham Risk Score (FRS). Correlation, multivariate logistic regression, and receiver operating characteristic curve analyses were used to compare the predictive performance.
RESULTS
FRS increased with increasing US-determined NAFPD severity (r = 0.624, p < 0.001), with a concomitant increase in the odds ratio for intermediate/high CHD risk. There was no difference between the predictive performance of US-determined NAFLD and NAFPD severities for intermediate/high CHD risk (p = 0.17). The combination of US-determined NAFPD and NAFLD severities significantly improved the differentiation between intermediate and high CHD risk (predictive value, 0.807; p < 0.001).
CONCLUSION
US-determined NAFPD severity was well-correlated with FRS and associated with the prevalence of intermediate/high CHD risk. The combination of US-determined NAFPD and NAFLD severities may be useful for predicting CHD risk.

MeSH Terms

Coronary Disease*
Humans
Logistic Models
Non-alcoholic Fatty Liver Disease
Odds Ratio
Pancreas*
Pancreatic Diseases
Predictive Value of Tests
Prevalence
Retrospective Studies
Risk Factors
ROC Curve
Ultrasonography
Young Adult

Figure

• 

  Fig. 1 Ultrasonographic findings of the pancreas based on the degree of steatosis. A. Non-fatty pancreas: the pancreatic echogenicity (right, arrow) is equal to the renal cortical echogenicity (left, arrowhead). B. Mild fatty pancreas: the pancreatic echogenicity (right, arrow) is higher than the renal cortical echogenicity (left, arrowhead); however, pancreatic echogenicity is definitely lower than the retroperitoneal fat echogenicity (right, open arrow). C. Moderate fatty pancreas: the pancreatic echogenicity (right, arrow) is higher than the renal cortical echogenicity (left, arrowhead) and slightly lower than the retroperitoneal fat echogenicity (right, open arrow). D. Severe fatty pancreas: the pancreatic echogenicity (right, arrow) is higher than the renal cortical echogenicity (left, arrowhead) and equal to the retroperitoneal fat echogenicity (right, open arrow).

• 

  Fig. 2 Ultrasonographic findings of the liver based on the degree of steatosis. A. Normal liver: the liver and the kidney have the same echogenicity (left). There is preservation of the echo line in the portal vein wall (right, arrow). B. Mild fatty liver: slight increase in the liver echogenicity, with echogenic discrepancy between the liver and the kidney (left), and preservation of the echo line in the portal vein wall (right, arrow). C. Moderate fatty liver: increased liver echogenicity, with echogenic discrepancy between the liver and the kidney (left), and loss of the echo line from the portal vein wall (right, arrow). D. Severe fatty liver: marked increase in the hepatic echogenicity, with echogenic discrepancy between the liver and the kidney (left), and poor visualization of the diaphragm (right, arrowheads).

• 

  Fig. 3 ROC curves for predicting intermediate/high coronary heart disease risk. The AUC was calculated for US-determined NAFPD alone, US-determined NAFLD alone, and a combination of both. AUC = area under the ROC curve, NAFLD = non-alcoholic fatty liver disease, NAFPD = non-alcoholic fatty pancreas disease, ROC = receiver operating characteristic, US = ultrasound

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