Lipid accumulation in the pancreas: clinical significance of NAFPD (non-alcoholic fatty pancreas disease)

Pancreatic lipid accumulation - which is known as NAFPD (non-alcoholic fatty pancreas disease) - has gained an increasing attention in the last couple of years. Previously, this alteration was mentioned using different names. Undoubtedly, the term of NAFPD is still rarely used in the Hungarian scientific literature, even the proper translation should be considered difficult. Pancreatic lipid accumulation is a clinical manifestation of ectopic occurrence of adipose tissue. NAFPD can be diagnosed by different imaging modalities. Although proper quantification of pancreatic lipid accumulation is challenging, ultrasonography and computed tomography are used in clinical practice. The prevalence of NAFPD was about 30-35% in different adult populations but a relatively higher frequency might also be observed in children and adolescents with obesity. NAFPD may influence both endocrine and exocrine functions of the pan-creas. Clinical studies documented a close correlation between NAFPD and type 2 diabetes/metabolic syndrome. Local consequences of pancreatic lipid accumulation are less recognized but clinical observations suggested that NAFPD might play a role in the development of acute and chronic pancreatitis, pancreatic cancer, and pancreatic exo-crine dysfunction. Therapeutically, weight loss in patients with obesity, due to life-style modification, pharmacological intervention or bariatric surgery, may reduce pancreatic lipid accumulation. Importantly, antihyperglycemic treatment of patients with type 2 diabetes should be performed by using antidiabetic drugs providing not only proper glycaemic control but even weight loss. NAFPD is a relatively new clinical entity which is rather common and probably under -diagnosed. Basic and new data about NAFPD are of importance for clinicians working in the field of different special-ties and sub-specialties (internal medicine, gastroenterology, diabetology, lipidology, obesitology, surgery).