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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Mericq, Veronica / Toppari, Jorma

IMPACT FACTOR 2018: 1.239

CiteScore 2018: 1.22

SCImago Journal Rank (SJR) 2018: 0.507
Source Normalized Impact per Paper (SNIP) 2018: 0.562

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Volume 32, Issue 1


Fatty pancreas in relation to insulin resistance and metabolic syndrome in children with obesity

Marwa ElhadyORCID iD: https://orcid.org/0000-0002-7785-3736 / Amira Aly Ahmed Mahmoud ElazabORCID iD: https://orcid.org/0000-0002-5783-4781 / Karima Abdelfattah Bahagat / Naglaa Abdelmoneam Abdallah / Gamil El-Sayed Ibrahim
Published Online: 2018-12-07 | DOI: https://doi.org/10.1515/jpem-2018-0315



Ectopic visceral fat is a major risk factor for obesity complications including insulin resistance and metabolic syndrome. Ultrasonography is a simple bedside screening tool used for the assessment of ectopic visceral fat including fatty pancreas. This study investigates the association between insulin resistance, metabolic syndrome and fatty pancreas detected by ultrasound in children with obesity.


This case-control study included 50 prepubertal obese (body mass index [BMI] ≥95th age- and sex-specific percentiles) and 30 lean children (BMI 5th–85th age- and sex-specific percentiles) as the control group. Clinical and laboratory parameters of metabolic syndrome including anthropometric indices of central obesity, blood pressure, fasting glucose and lipid profile were measured. Homeostasis model assessment-insulin resistance (HOMA-IR) was used to assess insulin resistance. Ultrasonographic assessment for pancreatic fat was done for all children.


Fifty-eight percent of obese children had fatty pancreas. Obese children with fatty pancreas had a higher rate of metabolic syndrome (p=0.013) and insulin resistance than those with non-fatty pancreas (p=0.012). Regression analysis revealed that fatty pancreas is an independent predictor of metabolic syndrome and insulin resistance. Fatty pancreas increases the risk for metabolic syndrome (odds ratio [OR] 11.40; 95% confidence interval [CI]: 2.69–48.22) and insulin resistance (OR 7.85; 95% CI: 2.20–28.05) in children with obesity.


Obese children have higher pancreatic fat accumulation than lean children. Obese children with fatty pancreas are more susceptible to insulin resistance and metabolic syndrome.

Keywords: fatty pancreas; insulin resistance; metabolic syndrome; obesity; ultrasonography


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About the article

Received: 2018-07-13

Accepted: 2018-11-11

Published Online: 2018-12-07

Published in Print: 2019-01-28

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Conflict of interest: None.

Funding: None.

No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 32, Issue 1, Pages 19–26, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2018-0315.

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