Increased pancreatic echogenicity and severity on US: Association with glycemic progression and incident diabetes

Purpose To investigate the relationship of increased pancreatic echogenicity (IPE) on US with the risk of glycemic progression and incident diabetes. Methods This retrospective study was approved by the institutional review board, with waiver of informed consent. Consecutive individuals who had undergone abdominal ultrasonography as part of a health examination at a tertiary hospital between January 2010 and June 2010 were included. IPE was defined as increased echogenicity of the pancreas compared with that of the left lobe of liver or renal cortex. IPE subdivided into mild, moderate, and severe degree comparing to the retroperitoneal fat echogenicity. Glycemic progression was defined as the development of new prediabetes or diabetes in normoglycemic subjects or as new diabetes in prediabetic subjects during the follow up period (median, 86.8 months; interquartile range, 84.1–90.6 months). The occurrence of incident diabetes, defined as a new diagnosis of diabetes during follow-up, was also analyzed. Results A total of 596 subjects were included in the follow-up analysis. Mean age of the 596 subjects was 48.6 years ± 11.5, and 55.4 % (n = 330) were female. The prevalence of IPE was 63.8 % (380/596). Mild, moderate, and severe IPE groups were 32.4%, 22.7%, and 8.7%, respectively. During the follow-up, 79 (13.3%) of the 596 subjects developed glycemic progression and new diabetes. Only presence of IPE was not associated with glycemic progression (P = 0.401). However, IPE more than moderate degree revealed significant associated with glycemic progression (hazard ratio, 1.38; 95% confidence interval: 1.920 – 8.300; P = 0.002). Conclusion Only presence of increased pancreatic echogenicity is not a risk factor of glycemic progression. IPE more than moderate degree is associated with impaired glycemic parameters and higher risk of glycemic progression and incident diabetes.