Incidence and risk factors of nonalcoholic fatty liver disease after pancreaticoduodenectomy in Korea: a multicenter retrospective cohort study
10.15747/ACNM.2024.16.3.125
- Author:
Chang-Sup LIM
1
;
Hongbeom KIM
;
In Woong HAN
;
Won-Gun YUN
;
Eunchae GO
;
Jaewon LEE
;
Kyung Chul YOON
;
So Jeong YOON
;
Sang Hyun SHIN
;
Jin Seok HEO
;
Yong Chan SHIN
;
Woohyun JUNG
Author Information
1. Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
- Publication Type:Original article
- From:
Annals of Clinical Nutrition and Metabolism
2024;16(3):125-133
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:This study aimed to investigate the incidence, risk factors, and clinical course of nonalcoholic fatty liver disease (NAFLD) following pancreaticoduodenectomy, focusing on the role of adjuvant chemotherapy and other metabolic changes.
Methods:A retrospective analysis was conducted on 189 patients who underwent pancreaticoduodenectomy between 2013 and 2016. NAFLD was diagnosed using computed tomography (CT) imaging, defined as a liver-tospleen attenuation ratio <0.9. Sarcopenia and sarcopenic obesity were assessed using preoperative CT scans. Logistic regression analysis was performed to identify risk factors for NAFLD development.
Results:The cumulative incidence of NAFLD increased over time, with rates of 15.9% at one year, 20.4% at three years, and 35.2% at five years post-pancreaticoduodenectomy. Adjuvant chemotherapy was identified as the only significant independent predictor of NAFLD development (odds ratio, 2.74; 95% confidence interval, 1.16-6.70; P=0.023). No significant associations were found between NAFLD and pancreatic enzyme replacement therapy (PERT), sarcopenia, or sarcopenic obesity. Serial analysis of NAFLD status in long-term survivors revealed dynamic changes, with some patients experiencing spontaneous remission or recurrence.
Conclusion:NAFLD is a common, progressive complication following pancreaticoduodenectomy, particularly in patients receiving adjuvant chemotherapy. Although no significant associations with PERT or sarcopenia were observed, these areas warrant further investigation. Long-term monitoring and targeted management strategies are recommended to address NAFLD in this population. Future prospective studies are needed to elucidate the natural history and contributing factors of NAFLD after pancreaticoduodenectomy.
