超音波検査技術

Introduction: This study aimed to investigate the association between pancreatic steatosis observed on ultrasonography and visceral fat, body composition, and steatotic liver disease (SLD) classification.

Materials and Methods: We retrospectively analyzed 102 patients (87 men and 15 women) who underwent abdominal ultrasonography, computed tomography (CT), and body composition analysis at our hospital for suspected SLD. Hepatic and pancreatic steatosis were graded using ultrasonography. Associations were evaluated between steatosis severity and body mass index (BMI), CT-derived subcutaneous and visceral fat areas, body fat percentage, muscle mass, and skeletal muscle mass measured using body composition analysis, as well as SLD classification.

Results: Pancreatic steatosis was identified in 90 of 102 patients (88%), including 21 with mild, 20 with moderate, and 49 with severe grades. Increasing severity of pancreatic steatosis demonstrated a moderate correlation with visceral fat area (ρ＝0.506) and weak correlations with subcutaneous fat area (ρ＝0.348) and BMI (ρ＝0.379). Pancreatic steatosis was significantly associated with the presence of metabolic dysfunction-associated steatotic liver disease (MASLD) and showed a strong association with metabolic dysfunction-associated steatohepatitis (MASH). The severity of pancreatic steatosis differed in patients with alcohol-associated liver disease, and although an association with visceral fat area was indicated, the degree of steatosis could not be explained by fat accumulation alone, indicating a possible effect of pancreatic fibrosis.

Conclusion: Ultrasonographic grading of pancreatic steatosis may function as a visceral adiposity indicator and may help elucidate the pathophysiology of MASLD and MASH within the SLD spectrum.