胰腺脂肪沉积的危险因素及相关疾病的研究进展

doi:10.16150/j.1671-2870.2025.01.011

摘要/Abstract

摘要：

胰腺脂肪沉积（intrapancreatic fat deposition，IPFD）被定义为胰腺中脂肪的弥漫性存在，伴随术语是脂肪胰（fatty pancreas，FP），是指高于正常上限的IPFD（脂肪含量≥9.5%）。胰腺的脂肪变化也已被证明至少影响了全球16%的人口。IPFD的常见危险因素包括人群特点（年龄、性别、种族）、饮食、肥胖与代谢综合征、非酒精性脂肪性肝病、代谢功能障碍相关脂肪性肝病、代谢功能障碍相关脂肪变性肝病、铁超载、遗传疾病、胰管堵塞和其他可能相关的因素（如细菌病毒感染、多囊卵巢综合征、甲状腺疾病等）。现有研究已明确，IPFD是胰腺炎、胰腺癌及糖尿病发生、发展的关键危险因素；此外，新近证据表明其可能参与了胰瘘、移植后排斥反应和动脉粥样硬化等病理过程。诊断IPFD目前主要依靠影像学检查，而随着人工智能（artificial intelligence， AI）技术的进步，未来AI-影像学技术可能为IPFD诊断提供更加完备的依据。针对IPFD的常用干预措施包括生活方式的改变（如减肥、健康饮食、定期锻炼等）、药物治疗和减肥手术。目前，对于IPFD的认知仍不够明确。本文对IPFD的高危因素、诊断、危害和干预措施等相关文献进行综述，有助于提高临床医师对IPFD的认知。

关键词: 胰腺脂肪沉积, 危险因素, 胰腺炎, 糖尿病, 胰腺癌, 影像学

Abstract:

Intrapancreatic fat deposition (IPFD) is defined as the diffuse accumulation of fat within the pancreas. A related term, fatty pancreas (FP), refers to an IPFD fat content of ≥9.5%, which exceeds the normal upper limit. Changes in pancreatic fat content have been shown to affect at least 16% of the global population. Known risk factors for IPFD include demographic characteristics (age, sex, ethnicity), dietary patterns, obesity and metabolic syndrome, non-alcoholic fatty liver disease (NAFLD), metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction-associated fatty liver disease (MAFLD), iron overload, genetic disorders, pancreatic duct obstruction, and other potentially related conditions such as bacterial/viral infections, polycystic ovary syndrome, thyroid disorders. Accumulating evidence has established IPFD as a critical risk factor for the pathogenesis and progression of pancreatitis, pancreatic cancer, and diabetes mellitus; additionally, emerging evidence suggests its potential involvement in pancreatic fistula, post-transplant rejection, and atherosclerosis. Currently, the diagnosis of IPFD primarily relies on imaging techniques. With the rapid development of artificial intelligence (AI), AI-assisted imaging is expected to provide more accurate and comprehensive diagnostic tools for IPFD in the near future. Common intervention strategies for IPFD include lifestyle modifications (such as weight loss, dietary optimization, and regular physical activity), pharmacological treatments, and bariatric surgery. Currently, the understanding of IPFD is still unclear, so a review of the risk factors, diagnosis, harms, and intervention measures for IPFD would help improve clinical awareness of IPFD.

Key words: Intrapancreatic fat deposition, Risk factors, Pancreatitis, Diabetes, Pancreatic cancer, Imaging

中图分类号:

R576

雷朝闻尉, 饶佳玲, 周梦雪, 杨虹. 胰腺脂肪沉积的危险因素及相关疾病的研究进展[J]. 诊断学理论与实践, 2025, 24(01): 72-79.

LEICHAO Wenwei, RAO Jialing, ZHOU Mengxue, YANG Hong. Advances in research on risk factors and associated diseases of intrapancreatic fat deposition[J]. Journal of Diagnostics Concepts & Practice, 2025, 24(01): 72-79.

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