Digestive Diseases and Sciences

, Volume 64, Issue 1, pp 262–268 | Cite as

Ultrasonographic Nonalcoholic Fatty Pancreas Is Associated with Advanced Fibrosis in NAFLD: A Retrospective Analysis

  • Russell Rosenblatt
  • Amit Mehta
  • David Snell
  • Erika Hissong
  • Andrea Siobhan Kierans
  • Sonal KumarEmail author
Original Article



Nonalcoholic fatty pancreas disease (NAF-P) is strongly linked with nonalcoholic fatty liver disease (NAFLD), but its relationship with advanced liver disease is unknown.


This study investigated the association between NAF-P and both advanced fibrosis and nonalcoholic steatohepatitis (NASH).


This retrospective study evaluated adults with biopsy-proven NAFLD with a sonogram within 1 year of liver biopsy. NAF-P was diagnosed by comparing the echogenicity of the pancreas to the kidney and was graded by severity. The primary outcome was the effect of NAF-P on the presence of advanced fibrosis and NASH, while secondary outcomes included the association of extensive NAF-P (grade II/III). Propensity score matching for independent risk factors of advanced fibrosis (age, gender, body mass index, and diabetes) was performed.


One hundred and four patients were included in the study and 91 (87.5%) had NAF-P. After propensity score matching, NAF-P was significantly associated with advanced fibrosis (OR 10.52, p < 0.001) but not NASH (p = 0.27). Extensive NAF-P was predictive of advanced fibrosis (OR 3.35, p = 0.006) and NASH (OR 5.37, p < 0.001). NAF-P had a negative predictive value (NPV) of 93% for advanced fibrosis. When matching for the NAFLD fibrosis score in addition to the variables above, both NAF-P (OR 5.36, p = 0.001) and extensive NAF-P (OR 5.38, p = 0.002) still significantly predicted advanced fibrosis.


NAF-P is predictive of advanced fibrosis, even when controlling for independent predictors of advanced fibrosis and the NAFLD fibrosis score. NAF-P has an excellent NPV and is a safe, inexpensive finding that can rule out advanced fibrosis.


Nonalcoholic fatty liver disease Pancreas NASH Hepatic fibrosis 


Compliance with ethical standards

Conflict of interest

Sonal Kumar has received an advisory meeting honorarium from Gilead Sciences. The other authors have no conflicts to disclose.

Supplementary material

10620_2018_5295_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 15 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Russell Rosenblatt
    • 1
  • Amit Mehta
    • 2
  • David Snell
    • 2
  • Erika Hissong
    • 3
  • Andrea Siobhan Kierans
    • 4
  • Sonal Kumar
    • 1
    Email author
  1. 1.Division of Gastroenterology and HepatologyWeill Cornell MedicineNew YorkUSA
  2. 2.Department of MedicineWeill Cornell MedicineNew YorkUSA
  3. 3.Department of Pathology and Laboratory MedicineWeill Cornell MedicineNew YorkUSA
  4. 4.Division of RadiologyWeill Cornell MedicineNew YorkUSA

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