Investigation of Clinical and Laboratory Findings of 40–49-Year-Old Patients With Fatty Pancreas by Magnetic Resonance Imaging and Evaluation of the Potential Relationship With Metabolic Dysfunction-associated Steatotic Liver Disease (MASLD)

AIM: This study aimed to investigate the relationship between nonalcoholic fatty pancreas disease (NAFPD) and metabolic dysfunction-associated steatotic liver disease (MASLD), and to evaluate the effects of pancreatic steatosis on clinical and laboratory parameters in patients aged 40-49 years. The secondary aim was to identify independent predictors of pancreatic steatosis and discuss their clinical relevance for early detection and prevention. METHODS: This retrospective single-center study included 132 patients aged 40-49 years who underwent abdominal magnetic resonance imaging (MRI). Pancreatic and hepatic fat fractions were measured using a chemical shift-based MRI technique. Demographic data, comorbidities, and laboratory parameters were analyzed. Patients with a history of alcohol intake, pancreatitis, or incomplete data were excluded. RESULTS: Pancreatic steatosis was present in 35.6% of participants. Patients with pancreatic steatosis had significantly higher rates of diabetes mellitus (59.6% vs. 21.2%), obesity (61.7% vs. 14.1%), hypertension (38.3% vs. 17.6%), and hyperlipidemia (44.7% vs. 20%) (all P <0.01). Pancreatic steatosis was strongly associated with hepatic steatosis (80.9% vs. 11.8%, P <0.001). Fasting glucose, HbA1c, HOMA-IR, and triglycerides were higher, whereas HDL and amylase were lower in the steatosis group. In multivariate logistic regression, diabetes mellitus (OR 8.06, 95% CI: 1.15-56.76, P =0.036) and HOMA-IR (OR 1.54, 95% CI: 1.19-1.99, P =0.001) were identified as independent predictors of pancreatic steatosis. Among patients with pancreatic steatosis, 80.9% also had hepatic steatosis, demonstrating a significant association between pancreatic and hepatic fat accumulation. CONCLUSION: A significant association was found between pancreatic steatosis and metabolic risk factors such as diabetes, obesity, insulin resistance, and MASLD. MRI-based quantification provided accurate detection, supporting its value as the most reliable imaging modality for assessing pancreatic fat. Lifestyle interventions such as weight loss and physical activity may help mitigate pancreatic steatosis and related metabolic consequences. Further studies are needed to clarify causality and underlying pathways, such as lipotoxicity, inflammation, and β-cell dysfunction.