medinfoАктуальные проблемы теоретической и клинической медициныActual Problems of Theoretical and Clinical Medicine2790-12892790-1297Казахстанско-Российский медицинский университет10.64854/2790-1289-2026-53-3-01medinfo-1154Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL ARTICLESАССОЦИАЦИИ РАСЧЁТНОГО МРТ-ЖИРОВОГО ИНДЕКСА С КЛИНИКО-МЕТАБОЛИЧЕСКИМИ И ВОСПАЛИТЕЛЬНЫМИ ПОКАЗАТЕЛЯМИ У ВЗРОСЛЫХ С ФАКТОРАМИ РИСКА НЕАЛКОГОЛЬНОЙ ЖИРОВОЙ БОЛЕЗНИ ПОДЖЕЛУДОЧНОЙ ЖЕЛЕЗЫASSOCIATIONS OF THE CALCULATED MRI FAT INDEX WITH CLINICAL, METABOLIC AND INFLAMMATORY PARAMETERS IN ADULTS WITH RISK FACTORS FOR NON-ALCOHOLIC FATTY PANCREATIC DISEASEhttps://orcid.org/0009-0006-7288-4986ЖангерееваА. К.ZhangereyevaA. K.

докторант 

doctoral student at Astana Medical University

anelya.9806@gmail.comhttps://orcid.org/0000-0001-5721-6409РахметоваВ. С.RakhmetovaV. S.

доктор медицинских наук, профессор кафедры внутренних болезней с курсом нефрологии, гематологии, аллергологии и иммунологии 

Doctor of Medical Sciences, Professor, Department of Internal Medicine with a Course in Nephrology, Hematology, Allergology and Immunology, Astana Medical University

venerarakhmetova@gmail.comhttps://orcid.org/0009-0002-5561-5451ЖангереевА. Т.ZhangereyevA. T.

директор «Центра аналитического тестирования» 

Director of the Analytical Testing Center

testowallker@gmail.comНАО «Медицинский университет Астана»КазахстанAstana Medical UniversityKazakhstan«Центр аналитического тестирования», Казахстан, АстанаКазахстанAnalytical Testing CenterKazakhstan202605102026031154Copyright © Жангереева А., Рахметова В., Жангереев А., 20262026Жангереева А., Рахметова В., Жангереев А.Zhangereyeva A., Rakhmetova V., Zhangereyev A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://kazrosmedjournal.krmu.edu.kz/jour/article/view/1154Актуальность

Актуальность.Накопление жира в поджелудочной железе связано с возрастом, ожирением и метаболическими нарушениями. Вклад отдельных метаболических и воспалительных показателей после взаимной корректировки остаётся неясным.

Цель исследования

Цель исследования: оценить связи расчётного полуколичественного МРТ-жирового индекса поджелудочной железы с клинико-антропометрическими, метаболическими и воспалительными показателями у взрослых с факторами метаболического риска.

Материалы и методы

Материалы и методы: выполнен поперечный анализ проспективно собранных данных 150 взрослых в возрасте 30–60 лет, обследованных в Астане с 25 октября 2025 года по 30 апреля 2026 года. МРТ-жировой индекс рассчитывали по двухэховым химически-сдвиговым изображениям; он не эквивалентен стандартизированной MRI-PDFF. Применяли критерий Краскела–Уоллиса, корреляцию Спирмена, многопараметрическую гамма-регрессию и анализы чувствительности. Множественные сравнения корректировали методом Бенджамини–Хохберга.

Результаты

Результаты: медиана индекса составила 5,70 [2,60–9,83] %. Наиболее выраженные положительные корреляции выявлены с возрастом (ρ=0,445), ИМТ (ρ=0,426), HbA1c (ρ=0,400), HOMA-IR (ρ=0,385), интерлейкином-6 (ρ=0,368) и инсулином (ρ=0,354); с ЛПВП связь была обратной (ρ=−0,240). В полной гамма-модели статистически значимой оставалась только связь с возрастом: отношение средних 1,510 на одно стандартное отклонение (95 % ДИ 1,254–1,818; p<0,001). Связи с полом, ИМТ и интерлейкином-6 достигали статистической значимости только в дополнительной линейной модели.

Выводы

Выводы: в нескорректированном анализе МРТ-жировой индекс был связан с рядом антропометрических, метаболических и воспалительных показателей. После взаимной корректировки наиболее устойчивой была связь с возрастом. Полуколичественный характер индекса и зависимость остальных ассоциаций от модели ограничивают клиническую интерпретацию результатов.

Pancreatic fat accumulation is associated with age, obesity, and metabolic abnormalities. The contributions of individual metabolic and inflammatory measures after mutual adjustment remain unclear.

Objective

Objective: To assess associations of a calculated semiquantitative pancreatic MRI fat index with clinical, anthropometric, metabolic, and inflammatory measures in adults with metabolic risk factors.

Materials and Methods

Materials and Methods: This cross-sectional analysis used prospectively collected data from 150 adults aged 30–60 years examined in Astana between 25 October 2025 and 30 April 2026. The MRI fat index was calculated from dual-echo chemical-shift images and was not equivalent to standardized MRI-PDFF. Analyses included Kruskal–Wallis tests, Spearman correlations, multivariable gamma regression, and sensitivity analyses. Multiple comparisons were adjusted using the Benjamini–Hochberg method.

Results

Results: The median index was 5.70 [2.60–9.83] %. The strongest positive correlations were with age (ρ=0.445), BMI (ρ=0.426), HbA1c (ρ=0.400), HOMA-IR (ρ=0.385), interleukin-6 (ρ=0.368), and insulin (ρ=0.354); HDL cholesterol was inversely correlated (ρ=−0.240). In the full gamma model, only age remained statistically significant, with a mean ratio of 1.510 per standard deviation (95 % CI 1.254–1.818; p<0.001). Associations with sex, BMI, and interleukin-6 reached statistical significance only in the additional linear model.

Conclusion

Conclusion: In unadjusted analyses, the MRI fat index was associated with several anthropometric, metabolic, and inflammatory measures. After mutual adjustment, the association with age was the most consistent. The semiquantitative nature of the index and the dependence of other associations on model choice limit the clinical interpretation of these findings.

поджелудочная железаинтрапанкреатический жирхимически-сдвиговая МРТметаболический рискинсулинорезистентностьинтерлейкин-6ожирение.pancreasintrapancreatic fatchemical-shift MRImetabolic riskinsulin resistanceinterleukin-6obesity.ReferencesSaisho, Y., Butler, A. E., Meier, J. J., et al. (2007). Pancreas volumes in humans from birth to age one hundred taking into account sex, obesity, and presence of type-2 diabetes. Clinical Anatomy, 20(8), 933-942. DOI: 10.1002/ca.20543.Saisho Y, Butler AE, Meier JJ, et al. Pancreas volumes in humans from birth to age one hundred taking into account sex, obesity, and presence of type-2 diabetes. Clin Anat. 2007;20(8):933–942. doi:10.1002/ca.20543.Sepe, P. S., Ohri, A., Sanaka, S., et al. (2011). A prospective evaluation of fatty pancreas by using EUS. Gastrointestinal Endoscopy, 73(5), 987-993. DOI: 10.1016/j.gie.2011.01.015.Sepe PS, Ohri A, Sanaka S, et al. A prospective evaluation of fatty pancreas by using EUS. Gastrointest Endosc. 2011;73(5):987–993. doi:10.1016/j.gie.2011.01.015.Lee, J. S., Kim, S. H., Jun, D. W., et al. (2009). Clinical implications of fatty pancreas: Correlations between fatty pancreas and metabolic syndrome. World Journal of Gastroenterology, 15(15), 1869-1875. DOI: 10.3748/wjg.15.1869.Lee JS, Kim SH, Jun DW, et al. Clinical implications of fatty pancreas: correlations between fatty pancreas and metabolic syndrome. World J Gastroenterol. 2009;15(15):1869–1875. doi:10.3748/wjg.15.1869.Begovatz, P., Koliaki, C., Weber, K., et al. (2015). Pancreatic adipose tissue infiltration, parenchymal steatosis and beta cell function in humans. Diabetologia, 58(7), 1646-1655. DOI: 10.1007/s00125-015-3544-5.Begovatz P, Koliaki C, Weber K, et al. Pancreatic adipose tissue infiltration, parenchymal steatosis and beta cell function in humans. Diabetologia. 2015;58(7):1646–1655. doi:10.1007/s00125-015-3544-5.Kato, S., Iwasaki, A., Kurita, Y., et al. (2019). Three-dimensional analysis of pancreatic fat by fat-water magnetic resonance imaging provides detailed characterization of pancreatic steatosis with improved reproducibility. PLOS ONE, 14(12), e0224921. DOI: 10.1371/journal.pone.0224921.Kato S, Iwasaki A, Kurita Y, et al. Three-dimensional analysis of pancreatic fat by fat-water magnetic resonance imaging provides detailed characterization of pancreatic steatosis with improved reproducibility. PLoS One. 2019;14(12):e0224921. doi:10.1371/journal.pone.0224921.Wong, V. W. S., Wong, G. L. H., Yeung, D. K. W., et al. (2014). Fatty pancreas, insulin resistance, and β-cell function: A population study using fat-water magnetic resonance imag-ing. The American Journal of Gastroenterology, 109(4), 589-597. DOI: 10.1038/ajg.2014.1.Wong VWS, Wong GLH, Yeung DKW, et al. Fatty pancreas, insulin resistance, and β-cell function: a population study using fat-water magnetic resonance imaging. Am J Gastroenterol. 2014;109(4):589–597. doi:10.1038/ajg.2014.1.Heber, S. D., Hetterich, H., Lorbeer, R., et al. (2017). Pancreatic fat content by magnetic resonance imaging in subjects with prediabetes, diabetes, and controls from a general popula-tion without cardiovascular disease. PLOS ONE, 12(5), e0177154. DOI: 10.1371/journal.pone.0177154.Rospleszcz S, Machann J, Sellner S, 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. doi:10.1371/journal.pone.0177154.Ballester-Vallés, C., Flores-Méndez, J., Delgado-Moraleda, J., et al. (2020). Hepatic and pancreatic fat as imaging biomarkers of metabolic syndrome. Radiología (English Edition), 62(2), 122-130. DOI: 10.1016/j.rx.2019.05.010.Ballester-Vallés C, Flores-Méndez J, Delgado-Moraleda J, et al. Hepatic and pancreatic fat as imaging biomarkers of metabolic syndrome. Radiologia (Engl Ed). 2020;62(2):122–130. doi:10.1016/j.rx.2019.05.010.Tushuizen, M. E., Bunck, M. C., Pouwels, P. J., et al. (2007). Pancreatic fat content and beta-cell function in men with and without type 2 diabetes. Diabetes Care, 30(11), 2916-2921. DOI: 10.2337/dc07-0326.Tushuizen ME, Bunck MC, Pouwels PJ, et al. Pancreatic fat content and beta-cell function in men with and without type 2 diabetes. Diabetes Care. 2007;30(11):2916–2921. doi:10.2337/dc07-0326.van der Zijl, N. J., Goossens, G. H., Moors, C. C. M., et al. (2011). Ectopic fat storage in the pancreas, liver, and abdominal fat depots: Impact on β-cell function in individuals with impaired glucose metabolism. The Journal of Clinical Endocrinology & Metabolism, 96(2), 459-467. DOI: 10.1210/jc.2010-1722.van der Zijl NJ, Goossens GH, Moors CCM, et al. Ectopic fat storage in the pancreas, liver, and abdominal fat depots: impact on β-cell function in individuals with impaired glucose metabolism. J Clin Endocrinol Metab. 2011;96(2):459–467. doi:10.1210/jc.2010-1722.Kühn, J. P., Berthold, F., Mayerle, J., et al. (2015). Pancreatic steatosis demonstrated at MR imaging in the general population: Clinical relevance. Radiology, 276(1), 129-136. DOI: 10.1148/radiol.15140446.Kühn JP, Berthold F, Mayerle J, et al. Pancreatic steatosis demonstrated at MR imaging in the general population: clinical relevance. Radiology. 2015;276(1):129–136. doi:10.1148/radiol.15140446.Chin, S. O., Hwang, Y. C., Cho, I. J., Jeong, I. K., Ahn, K. J., & Chung, H. Y. (2021). Pancreatic fat accumulation is associated with decreased β-cell function and deterioration in glucose tolerance in Korean adults. Diabetes/Metabolism Research and Reviews, 37(7), e3425. DOI: 10.1002/dmrr.3425.Chin SO, Hwang YC, Cho IJ, Jeong IK, Ahn KJ, Chung HY. Pancreatic fat accumulation is associated with decreased β-cell function and deterioration in glucose tolerance in Korean adults. Diabetes Metab Res Rev. 2021;37(7):e3425. doi:10.1002/dmrr.3425.Singh, R. G., Nguyen, N. N., Cervantes, A., Alarcon Ramos, G. C., Cho, J., & Petrov, M. S. (2019). Associations between intra-pancreatic fat deposition and circulating levels of cyto-kines. Cytokine, 120, 107-114. DOI: 10.1016/j.cyto.2019.04.011.Singh RG, Nguyen NN, Cervantes A, Alarcon Ramos GC, Cho J, Petrov MS. Associations between intra-pancreatic fat deposition and circulating levels of cytokines. Cytokine. 2019;120:107–114. doi:10.1016/j.cyto.2019.04.011.Livingstone, R. S., Begovatz, P., Kahl, S., et al. (2014). Initial clinical application of mod-ified Dixon with flexible echo times: Hepatic and pancreatic fat assessments in comparison with ¹H MRS. Magnetic Resonance Materials in Physics, Biology and Medicine, 27(5), 397-405. DOI: 10.1007/s10334-013-0421-4.Schwenzer NF, Machann J, Martirosian P, et al. Initial clinical application of modified Dixon with flexible echo times: hepatic and pancreatic fat assessments in comparison with ¹H MRS. MAGMA. 2014;27(5):397–405. doi:10.1007/s10334-013-0421-4.Yoon, J. H., Lee, J. M., Lee, K. B., et al. (2016). Pancreatic steatosis and fibrosis: Quanti-tative assessment with preoperative multiparametric MR imaging. Radiology, 279(1), 140-150. DOI: 10.1148/radiol.2015142254.Yoon JH, Lee JM, Lee KB, et al. Pancreatic steatosis and fibrosis: quantitative assessment with preoperative multiparametric MR imaging. Radiology. 2016;279(1):140–150. doi:10.1148/radiol.2015142254.Yuan, F., Song, B., Huang, Z., Xia, C., & Liu, X. (2018). Quantification of pancreatic fat with dual-echo imaging at 3.0-T MR in clinical application: How do the corrections for T1 and T2* relaxation effect work and simplified correction strategy. Acta Radiologica, 59(9), 1021-1028. DOI: 10.1177/0284185117745908.Yuan F, Song B, Huang Z, Xia C, Liu X. Quantification of pancreatic fat with dual-echo imaging at 3.0-T MR in clinical application: how do the corrections for T1 and T2* relaxation effect work and simplified correction strategy. Acta Radiol. 2018;59(9):1021–1028. doi:10.1177/0284185117745908.Yu, H., Shimakawa, A., McKenzie, C. A., et al. (2008). Multiecho water-fat separation and simultaneous R2* estimation with multifrequency fat spectrum modeling. Magnetic Resonance in Medicine, 60(5), 1122-1134. DOI: 10.1002/mrm.21737.Yu H, Shimakawa A, McKenzie CA, et al. Multiecho water-fat separation and simultaneous R2* estimation with multifrequency fat spectrum modeling. Magn Reson Med. 2008;60(5):1122–1134. doi:10.1002/mrm.21737.Meisamy, S., Hines, C. D. G., Hamilton, G., et al. (2011). Quantification of hepatic stea-tosis with T1-independent, T2*-corrected MR imaging with spectral modeling of fat: Blinded comparison with MR spectroscopy. Radiology, 258(3), 767-775. DOI: 10.1148/radiol.10100708.Meisamy S, Hines CDG, Hamilton G, et al. Quantification of hepatic steatosis with T1-independent, T2*-corrected MR imaging with spectral modeling of fat: blinded comparison with MR spectroscopy. Radiology. 2011;258(3):767–775. doi:10.1148/radiol.10100708.Kang, G. H., Cruite, I., Shiehmorteza, M., et al. (2011). Reproducibility of MRI-determined proton density fat fraction across two different MR scanner platforms. Journal of Magnetic Resonance Imaging, 34(4), 928-934. DOI: 10.1002/jmri.22701.Kang GH, Cruite I, Shiehmorteza M, et al. Reproducibility of MRI-determined proton density fat fraction across two different MR scanner platforms. J Magn Reson Imaging. 2011;34(4):928–934. doi:10.1002/jmri.22701.Qi, X., Zhang, F., Yao, W., Cheng, X., & Guan, L. (2026). MRI measurements of pancre-atic fat content in the general population and their relationship with age, gender, and body mass index. Medicine, 105(13), e48133. DOI: 10.1097/MD.0000000000048133.Qi X, Zhang F, Yao W, Cheng X, Guan L. MRI measurements of pancreatic fat content in the general population and their relationship with age, gender, and body mass index. Medicine (Baltimore). 2026;105(13):e48133. doi:10.1097/MD.0000000000048133.Yamazaki, H., Tauchi, S., Kimachi, M., et al. (2018). Association between pancreatic fat and incidence of metabolic syndrome: A 5-year Japanese cohort study. Journal of Gastroenterology and Hepatology, 33(12), 2048-2054. DOI: 10.1111/jgh.14266.Yamazaki H, Tauchi S, Kimachi M, Kodama Y. Association between pancreatic fat and incidence of metabolic syndrome: a 5-year Japanese cohort study. J Gastroenterol Hepatol. 2018;33(12):2048–2054. doi:10.1111/jgh.14266.Dong, X., Zhu, Q., Yuan, C., et al. (2024). Associations of intrapancreatic fat deposition with incident diseases of the exocrine and endocrine pancreas: A UK Biobank prospective cohort study. The American Journal of Gastroenterology, 119(6), 1158-1166. DOI: 10.14309/ajg.0000000000002792.Dong X, 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):1158–1166. doi:10.14309/ajg.0000000000002792.Tene, L., Shelef, I., Schwarzfuchs, D., et al. (2018). The effect of long-term weight-loss intervention strategies on the dynamics of pancreatic-fat and morphology: An MRI RCT study. Clinical Nutrition ESPEN, 24, 82-89. DOI: 10.1016/j.clnesp.2018.01.008.Tene L, Shelef I, Schwarzfuchs D, et al. The effect of long-term weight-loss intervention strategies on the dynamics of pancreatic-fat and morphology: an MRI RCT study. Clin Nutr ESPEN. 2018;24:82–89. doi:10.1016/j.clnesp.2018.01.008.Taylor, R., Al-Mrabeh, A., Zhyzhneuskaya, S., et al. (2018). Remission of human type 2 diabetes requires decrease in liver and pancreas fat content but is dependent upon capacity for β-cell recovery. Cell Metabolism, 28(4), 547-556.e3. DOI: 10.1016/j.cmet.2018.07.003.Taylor R, Al-Mrabeh A, Zhyzhneuskaya S, et al. Remission of human type 2 diabetes requires decrease in liver and pancreas fat content but is dependent upon capacity for β-cell recovery. Cell Metab. 2018;28(4):547–556.e3. doi:10.1016/j.cmet.2018.07.003.

The authors declare that there are no conflicts of interest present.