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. 2010 Sep 14;16(34):4329-34.
doi: 10.3748/wjg.v16.i34.4329.

Associated factors for a hyperechogenic pancreas on endoscopic ultrasound

Cheol Woong Choi  1 , Gwang Ha Kim, Dae Hwan Kang, Hyung Wook Kim, Dong Uk Kim, Jeong Heo, Geun Am Song, Do Youn Park, Suk Kim
Affiliations

Associated factors for a hyperechogenic pancreas on endoscopic ultrasound

Cheol Woong Choi et al. World J Gastroenterol. .

Abstract

Aim: To identify the associated risk factors for hyperechogenic pancreas (HP) which may be observed on endoscopic ultrasound (EUS) and to assess the relationship between HP and obesity.

Methods: From January 2007 to December 2007, we prospectively enrolled 524 consecutive adults who were scheduled to undergo EUS. Patients with a history of pancreatic disease or with hepatobiliary or advanced gastrointestinal cancer were excluded. Finally, 284 patients were included in the analyses. We further analyzed the risk of HP according to the categories of visceral adipose tissue (VAT) and subcutaneous adipose tissue in 132 patients who underwent abdominal computed tomography scans.

Results: On univariate analysis, age older than 60 years, obesity (body mass index > 25 kg/m(2)), fatty liver, diabetes mellitus, hypertension and hypercholesterolemia were identified as risk factors associated with HP (P < 0.05). On multivariate analysis, fatty liver [P = 0.008, odds ratio (OR) = 2.219], male gender (P = 0.013, OR = 2.636), age older than 60 years (P = 0.001, OR = 2.874) and hypertension (P = 0.044, OR = 2.037) were significantly associated with HP. In the subgroup analysis, VAT was a statistically significant risk factor for HP (P = 0.010, OR = 5.665, lowest quartile vs highest quartile).

Conclusion: HP observed on EUS was associated with fatty liver, male gender, age older than 60 years, hypertension and VAT.

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Figures

Figure 1
Figure 1
Flow chart indicating the progression from the initial assessment when first referred for endoscopic ultrasound to the final analysis. EUS: Endoscopic ultrasound; GI: Gastrointestinal; VAT: Visceral adipose tissue; SAT: Subcutaneous adipose tissue.
Figure 2
Figure 2
Echogenicity of the pancreas on endoscopic ultrasound. A: Normal echogenic pancreas; B: Hyperechogenic pancreas compared to kidney. P: Pancreas; K: Kidney.
Figure 3
Figure 3
Calculation of the abdominal adipose tissue distribution using computed tomography scans. The total adipose tissue (TAT) area was obtained by applying an adipose tissue threshold to a region of interest (ROI) that was traced around the dermis (1). An ROI was traced around the inner margin of the abdominal wall muscles, and an adipose tissue threshold was applied to determine the area of visceral adipose tissue (VAT) in the ROI (2). The subcutaneous adipose tissue area was then obtained by subtracting the VAT from the TAT.
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