Fat Distribution Within the Pancreas According to Diabetes Status and Insulin Traits

Growing body of evidence suggests that intra-pancreatic fat is associated with diabetes but whether distribution of intra-pancreatic fat across the regions of the pancreas has a pathophysiologic role is unknown. The study aimed to investigate the differences in intra-pancreatic fat deposition between the head, body, and tail of the pancreas, as well as the relationship between regional intra-pancreatic fat deposition and diabetes status and insulin traits. A total of 368 adults from the general population underwent magnetic resonance imaging on a 3 T scanner and intra-pancreatic fat was manually quantified in duplicate. Statistical models were adjusted for age, sex, ethnicity, body mass index, and liver fat. Intra-pancreatic fat deposition in the head, body, and tail of the pancreas did not differ significantly in adjusted models, in both the overall cohort and the three subgroups based on diabetes status. HOMA-IR and fasting insulin were significantly positively associated with fat in the tail and body of the pancreas. There was no significant association between regional intra-pancreatic fat and HOMA-β. The association of increased intra-pancreatic fat deposition in the tail and body regions with increased insulin resistance may have an important role in the early identification of patients at risk for developing insulin resistance and diseases that stem from it.