Poster Presentation The Pancreas Summit 2025

Associations of Intra-pancreatic Fat Deposition with Incident Pancreatic Neoplasms Differ According to Carcinoma Types: A Study in Non-obese Individuals With Intraductal Papillary Mucinous Neoplasms (#36)

Hiroki Oyama 1 , Tsuyoshi Hamada 1 , Daniel Nevo 2 , Yudai Nakai 3 , Yousuke Nakai 4 , Max S. Petrov 5
  1. Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Bunkyo-city, Tokyo, Japan
  2. Department of Statistics and Operations Research, Tel Aviv University, Tel Aviv, Israel
  3. Department of Radiology, Graduate School of Medicine, The University of Tokyo, Bunkyo-city, Tokyo, Japan
  4. Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women’s Medical University, Shinjuku-city, Tokyo, Japan
  5. School of Medicine, University of Auckland, Auckland, New Zealand

Background & Aims: Individuals with intraductal papillary mucinous neoplasms (IPMNs) are at a high risk of developing both carcinomas derived from and concomitant with IPMN.  We examined the associations of intra-pancreatic fat deposition (IPFD) with risks of these carcinoma types in non-obese patients.

Methods: Within a prospective cohort of 2,070 patients diagnosed with IPMNs, 48 patients with body mass index (BMI) < 25 kg/m2 who developed pancreatic carcinoma during long-term surveillance were matched with 215 carcinoma-free controls with BMI < 25 kg/m2.  IPFD was determined with the use of 3.0 T magnetic resonance imaging at IPMN diagnosis in all participants.  A multivariable logistic regression model was constructed to calculate odds ratios (ORs) for the risks of incident carcinomas.

Results: The association of IPFD with the risk of pancreatic carcinoma differed by the carcinoma types (Pheterogeneity = .011, after accounting for covariates).  In the multivariable analysis, there was a significant association of IPFD with carcinoma concomitant with IPMN (OR comparing the extreme quartiles, 4.17; 95% confidence interval, 1.16-15.0; Ptrend = .007) and no significant association with carcinoma derived from IPMN (OR, 0.42; 95% confidence interval, 0.02-8.83; Ptrend = .27).

Conclusions: IPFD is differentially associated with the risk of pancreatic carcinoma types even in non-obese patients.  Individuals with high IPFD are at a heightened risk of incident carcinoma concomitant with IPMN, but not carcinoma derived from IPMN.  This has important implications for understanding the pathogenesis of the distinct carcinoma types and optimizing IPMN surveillance.