Petrov MS, Taylor R. Intra-pancreatic fat deposition: bringing hidden fat to the fore. Nat Rev Gastroenterol Hepatol. 2022;19(3):153–68. https://doi.org/10.1038/S41575-021-00551-0.

Article  PubMed  Google Scholar 

Heber SD, Hetterich H, Lorbeer R, et al. Pancreatic fat content by magnetic resonance imaging in subjects with prediabetes, diabetes, and controls from a general population without cardiovascular disease. PLoS One. 2017;12(5):e0177154. https://doi.org/10.1371/journal.pone.0177154.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Souza M, Silva GP, Junior CRO, Amaral MJM, Lima LCV, Charatcharoenwitthaya P. Prevalence, clinical characteristics, and outcomes of fatty pancreas disease: an updated systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2025;37(2):137–46. https://doi.org/10.1097/MEG.0000000000002893.

Article  CAS  PubMed  Google Scholar 

Karaevren TT, Yorulmaz R, Cerit M, et al. Fatty pancreas disease in newly diagnosed type 2 diabetes patients: a case–control study on relationships with glycemic control and exocrine function. Diabetol Metab Syndr. 2025;17(1):107. https://doi.org/10.1186/s13098-025-01663-2.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Tushuizen ME, Bunck MC, Pouwels PJ, et al. Pancreatic fat content and β-cell function in men with and without type 2 diabetes. Diabetes Care. 2007;30(11):2916–21. https://doi.org/10.2337/dc07-0326.

Article  CAS  PubMed  Google Scholar 

Szczepaniak LS, Victor RG, Mathur R, et al. Pancreatic steatosis and its relationship to β-cell dysfunction in humans: racial and ethnic variations. Diabetes Care. 2012;35(11):2377–83. https://doi.org/10.2337/DC12-0701.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Dong X, Zhu Q, Yuan C, et al. Associations of intrapancreatic fat deposition with incident diseases of the exocrine and endocrine pancreas: a UK biobank prospective cohort study. Am J Gastroenterol. 2024;119(6):1158–66. https://doi.org/10.14309/ajg.0000000000002792.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Chan TT, Tse YK, Lui RNS, et al. Fatty pancreas is independently associated with subsequent diabetes mellitus development: a 10-year prospective cohort study. Clin Gastroenterol Hepatol. 2022;20(9):2014-2022.e4. https://doi.org/10.1016/J.CGH.2021.09.027.

Article  CAS  PubMed  Google Scholar 

Martin S, Sorokin EP, Thomas EL, et al. Estimating the effect of liver and pancreas volume and fat content on risk of diabetes: a Mendelian randomization study. Diabetes Care. 2022;45(2):460–8. https://doi.org/10.2337/dc21-1262.

Article  PubMed  Google Scholar 

Leybourne CB, Liu Y, Petrov MS. Excessive intrapancreatic fat deposition and risk of pancreatic diseases: longitudinal cohort evidence from a systematic review with population-attributable fraction analysis. Am J Gastroenterol. 2026;121(5):1071–81. https://doi.org/10.14309/ajg.0000000000003799.

Article  Google Scholar 

Singh RG, Yoon HD, Poppitt SD, Plank LD, Petrov MS. Ectopic fat accumulation in the pancreas and its biomarkers: a systematic review and meta-analysis. Diabetes Metab Res Rev. 2017;33(8):2918. https://doi.org/10.1002/DMRR.2918.

Article  Google Scholar 

Bi Y, Wang JL, Li ML, Zhou J, Sun XL. The association between pancreas steatosis and metabolic syndrome: a systematic review and meta-analysis. Diabetes Metab Res Rev. 2019;35(5):3142. https://doi.org/10.1002/DMRR.3142.

Article  Google Scholar 

Ahmad S, Sul HH, Danpanichkul P, Souza M. High prevalence of fatty pancreas disease in type 2 diabetes mellitus: a meta-analysis. Diabetes Res Clin Pract. 2026;113149. https://doi.org/10.1016/j.diabres.2026.113149.

Article  PubMed  Google Scholar 

Souza M, Amaral MJM, Moura FS, Lima LCV. Epidemiology and clinical characteristics of fatty pancreas disease in metabolic dysfunction-associated steatotic liver disease: a systematic review. J Gastroenterol Hepatol. 2026;41(4):1107–15. https://doi.org/10.1111/jgh.70312.

Article  PubMed  Google Scholar 

Yao WJ, Guo Z, Wang L, et al. Pancreas fat quantification with quantitative CT: an MRI correlation analysis. Clin Radiol. 2020;75(5):397.e1-397.e6. https://doi.org/10.1016/j.crad.2019.12.017.

Article  CAS  PubMed  Google Scholar 

Kim SY, Kim H, Cho JY, et al. Quantitative assessment of pancreatic fat by using unenhanced CT: pathologic correlation and clinical implications. Radiology. 2014;271(1):104–12. https://doi.org/10.1148/radiol.13122883.

Article  PubMed  Google Scholar 

Hu HH, Kim H, Nayak KS, Goran MI. Comparison of fat–water MRI and single-voxel MRS in the assessment of hepatic and pancreatic fat fractions in humans. Obesity. 2010;18(4):841–7. https://doi.org/10.1038/oby.2009.352.

Article  PubMed  Google Scholar 

Zhang J, Liu Y, Petrov MS. Validation of magnetic resonance imaging for quantification of intrapancreatic fat deposition using phantom and histologic comparators: a systematic review and meta-analysis. Eur Radiol. Published online March. 2026;23. https://doi.org/10.1007/s00330-026-12475-x.

Agon HC, Shen Y, Petrov MS. Effects of glucose-lowering medications on intrapancreatic fat deposition: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2026;27(6). https://doi.org/10.1111/obr.70087.

Wang Y, Liu Y, Petrov MS. The effects of metabolic bariatric surgery on intra-pancreatic fat deposition and total pancreas volume: a systematic review and meta-analysis. Obes Surg. 2025;35(4):1513–24. https://doi.org/10.1007/s11695-025-07778-9.

Article  PubMed  PubMed Central  Google Scholar 

Della Pepa G, Salamone D, Testa R, Bozzetto L, Costabile G. Intrapancreatic fat deposition and nutritional treatment: the role of various dietary approaches. Nutr Rev. 2024;82(12):1820–34. https://doi.org/10.1093/nutrit/nuad159.

Article  PubMed  Google Scholar 

Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021. https://doi.org/10.1136/BMJ.N71.

Article  PubMed  PubMed Central  Google Scholar 

Brooke BS, Schwartz TA, Pawlik TM. MOOSE reporting guidelines for meta-analyses of observational studies. JAMA Surg. 2021;156(8):787–8. https://doi.org/10.1001/JAMASURG.2021.0522.

Article  PubMed  Google Scholar 

Steven S, Hollingsworth KG, Small PK, et al. Weight loss decreases excess pancreatic triacylglycerol specifically in type 2 diabetes. Diabetes Care. 2016;39(1):158–65. https://doi.org/10.2337/dc15-0750.

Article  CAS  PubMed  Google Scholar 

Lim EL, Hollingsworth KG, Aribisala BS, Chen MJ, Mathers JC, Taylor R. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia. 2011;54(10):2506–14. https://doi.org/10.1007/s00125-011-2204-7.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Joshi T, Virostko J, Petrov MS. Artificial intelligence-based models for quantification of intra-pancreatic fat deposition and their clinical relevance: a systematic review of imaging studies. Eur Radiol. 2026;36(1):627–41. https://doi.org/10.1007/s00330-025-11808-6.

Article  PubMed  Google Scholar 

Higgins JP, Li T, Deeks JJ. Choosing effect measures and computing estimates of effect. In: Cochrane Handbook for Systematic Reviews of Interventions. Wiley; 2019. p. 143–76. https://doi.org/10.1002/9781119536604.ch6.

Chapter  Google Scholar 

Nadarajah C, Fananapazir G, Cui E, et al. Association of pancreatic fat content with type II diabetes mellitus. Clin Radiol. 2020;75(1):51–6. https://doi.org/10.1016/j.crad.2019.05.027.

Article  CAS  PubMed  Google Scholar 

Ma J, Song Z, Yan F. Detection of hepatic and pancreatic fat infiltration in type II diabetes mellitus patients with IDEAL-Quant using 3.0T MR: comparison with single-voxel proton spectroscopy. Chin Med J (Engl). 2014;127(20):3548–52.

Article  PubMed  Google Scholar 

Drevon D, Fursa SR, Malcolm AL. Intercoder reliability and validity of WebPlotDigitizer in extracting graphed data. Behav Modif. 2017;41(2):323–39. https://doi.org/10.1177/0145445516673998.

Article  PubMed  Google Scholar 

Wells GA, O’Connell D, Peterson J et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Accessed June 22, 2023. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp

Jackson D, Law M, Rücker G, Schwarzer G. The Hartung-Knapp modification for random‐effects meta‐analysis: a useful refinement but are there any residual concerns? Stat Med. 2017;36(25):3923–34. https://doi.org/10.1002/sim.7411.

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