【病理資訊】胰腺脂肪變性：一個(gè)新型臨床疾病
Pancreatic Steatosis: An Emerging Clinical Entity
Ramkissoon R, Gardner TB. Pancreatic Steatosis: An Emerging Clinical Entity.
American Journal of Gastroenterology. 2019 Nov;114(11):1726-1734. doi: 10.14309/ajg.0000000000000262. Review.
?文獻(xiàn)精選（含中文解讀)
Pancreatic steatosis is an emerging clinical entity whose pathophysiology, natural history, and long-term complications are poorly characterized in the current literature. Epidemiological and prospective studies have described prevalence rates between 16% and 35%. Although the natural history is not well known, there are strong associations with obesity, metabolic syndrome, type 2 diabetes mellitus, and nonalcoholic fatty liver disease. Ectopic fat accumulation of the pancreas can cause chronic, low-grade inflammation from adipocytokine imbalances that involve beta cells and acinar cells. This mechanism can lead to pancreatic endocrine and exocrine dysfunction and initiate carcinogenesis. Although it is associated with morbid conditions, pancreatic steatosis may be amendable to treatment with a healthy diet, less meat consumption, exercise, and smoking cessation. Pancreatic steatosis should factor into clinical decision-making and prognostication of patients with pancreatic and systemic disease. This review seeks to describe the pathophysiology, natural history, diagnosis, and complications of this emerging clinically relevant entity.
部分翻譯：
胰腺脂肪變性(Pancreatic Steatosis) 是一個(gè)新的臨床疾病， 但是目前的文獻(xiàn)對(duì)其病理生理學(xué)、自然病程和長(zhǎng)期并發(fā)癥的描述并不完善。流行病學(xué)和前瞻性研究發(fā)現(xiàn)大概有16%至35%的患病率。雖然自然病程并未完全所知，但和肥胖、代謝綜合征、II型糖尿病和非酒精性脂肪性肝病有很強(qiáng)的關(guān)聯(lián)性。由于異位脂肪堆積在胰腺所致脂肪炎癥因子失衡可以誘導(dǎo)β和腺泡細(xì)胞的慢性、低程度炎癥。這種機(jī)制可導(dǎo)致胰腺內(nèi)分泌和外泌物功能障礙，并引發(fā)癌癥。胰腺脂肪變性雖然會(huì)長(zhǎng)期存在，但可以通過(guò)健康飲食，少吃肉，運(yùn)動(dòng)和戒煙來(lái)改善病程。對(duì)于有胰腺和全身疾病患者做臨床決策和預(yù)后判斷，需要考慮胰腺脂肪變性。這篇綜述旨在描述這種新興的臨床相關(guān)疾病的病理生理學(xué)，自然史，診斷和并發(fā)癥。
l 文獻(xiàn)中重要的信息：
圖1：胰腺脂肪變性的發(fā)病機(jī)制和病理生理學(xué)。從肥胖開(kāi)始的病理生理圖譜，描述了NAFPD的發(fā)病機(jī)理并提出了導(dǎo)致胰腺疾病的機(jī)制。這包括內(nèi)分泌功能障礙，外分泌功能障礙和胰腺惡性腫瘤
II 文獻(xiàn)的概述：
1. 肥胖癥的日益普遍已成為一種全球流行病。
2. 肥胖者通過(guò)增強(qiáng)腫瘤壞死因子α和白介素（IL）-6的作用而處于慢性低度炎癥狀態(tài)。
3. 胰腺脂肪變性包括任何原因的在胰腺中的脂肪堆積。
4. NAFPD（非酒精性脂肪胰腺病）是一個(gè)較新的術(shù)語(yǔ)，用于與肥胖癥和代謝綜合征相關(guān)的胰腺脂肪變性的亞型。NAFPD可通過(guò)減肥和/或藥物療法逆轉(zhuǎn)。
5. 診斷：評(píng)估胰腺脂肪的黃金標(biāo)準(zhǔn)是組織學(xué)，正常胰腺脂肪含量6.2%。EUS最敏感的篩查工具。
6. 胰腺長(zhǎng)期脂肪積累會(huì)導(dǎo)致胰腺炎，胰腺壞死，以及胰腺腺癌。
lII 翻譯者：
