Objective: To explore potential effects of pancreatic fat content measured by computed  tomography (CT) on carotid plaque in patients with type 2 diabetes mellitus (T2DM).
Methods: T2DM patients who underwent an un-enhanced CT scan of the upper abdomen and ultrasound of the carotid artery were enrolled. The patients were divided into a non-plaque group and a plaque group (including hypoechoic plaque subgroup and non-hypoechoic plaque subgroup). The CT attenuation of pancreas and spleen were measured. Pancreas-to-spleen attenuation ratio (P/S) and the difference between pancreatic and splenic attenuation (P-S) were calculated. The cutoff values of P/S and P-S were obtained using receiver operating characteristic curves. Logistic regression models were used to evaluate association of P/S or P-S with carotid plaque or hypoechoic plaque.
Results: 337 patients were enrolled, including 101 cases in the non-plaque group, 146 cases in the hypoechoic plaque subgroup, and 90 cases in the non-hypoechoic plaque subgroup. P/S and P-S in hypoechoic plaque group were lower than those in non-plaque group, with a cutoff value of P/S and P-S as 0.72 and − 13.33, respectively. After adjusting for risk factors, P/S and P-S correlated with carotid plaque [for low P/S: OR (95% CI): 3.15 (1.47– 6.73), P = 0.0031; for low P-S: OR (95% CI): 2.84 (1.42– 5.66), P = 0.0031] as well as carotid hypoechoic plaque [for low P/S: OR (95% CI): 1.82 (1.07– 3.08), P = 0.0259; for low P-S: OR (95% CI): 1.82 (1.09– 3.02), P = 0.021].
Conclusion: T2DM patients with hypoechoic carotid plaque have higher pancreatic fat content than those without. Pancreatic steatosis correlates with carotid plaque and hypoechoic plaque in T2DM patients.
Keywords: atherosclerosis, computed tomography, diabetes mellitus, pancreatic steatosis