Exploring the relationship between nonalcoholic fatty liver disease and pancreatic cancer by computed tomographic survey

Intern Emerg Med. 2018 Mar;13(2):191-197. doi: 10.1007/s11739-017-1774-x. Epub 2017 Dec 12.

Abstract

Pancreatic cancer is difficult to diagnose in an early stage, and has the highest mortality of all types of cancer. Obesity, high body mass index, and increased abdominal girth are established risk factors. Some studies have postulated that there is a correlation between organ steatosis and pancreatic cancer. This study aims to explore whether nonalcoholic fatty liver disease (NAFLD) is a risk factor and a prognostic factor for pancreatic cancer. The study enrolled 557 patients (143 with and 414 without pancreatic cancer) who were diagnosed between January 2009 and December 2013. We reviewed the abdominal computed tomographic scans of the patients to confirm the diagnosis of NAFLD. Clinical parameters, laboratory data, and personal information were analyzed. NAFLD is an independent risk factor for pancreatic cancer according to adjusted multivariate logistic regression analysis (OR 2.63, 95% CI 1.24-5.58, p = 0.011). The Kaplan-Meier survival curve reveals that patients without NAFLD have longer survival than patients with NAFLD (p = 0.005, log-rank test). NAFLD is positively correlated with pancreatic cancer, a result suggesting that NAFLD may increase the incidence and risk of pancreatic cancer. Patients with pancreatic cancer and NAFLD have poorer overall survival than patients without NAFLD, perhaps, because dysregulated cytokine status leads to progression of pancreatic cancer. NAFLD may be a prognostic factor for pancreatic cancer.

Keywords: Abdominal fat; Computed tomography; Fatty liver; Pancreatic cancer.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Body Mass Index
  • Female
  • Humans
  • International Classification of Diseases / statistics & numerical data
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Non-alcoholic Fatty Liver Disease / epidemiology
  • Non-alcoholic Fatty Liver Disease / physiopathology*
  • Obesity / complications
  • Obesity / epidemiology
  • Pancreatic Neoplasms / epidemiology
  • Pancreatic Neoplasms / physiopathology*
  • Risk Factors
  • Sagittal Abdominal Diameter / physiology
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Tomography, X-Ray Computed / methods*