Abstract：
Hepatic steatosis has been described as a common finding in adults following total pancreatectomy with islet autotransplantation (TPIAT) but it is unknown if this occurs in children and adolescents.
To define the frequency of post-TPIAT hepatic steatosis in a sample of children and adolescents and to identify clinical predictors of incident steatosis post-TPIAT.
In this prospective study, consecutive participants at least 1-month post-TPIAT underwent a liver MRI with proton density fat fraction (PDFF) and blood draw at our pediatric academic medical center between April 2021 and January 2022. Comparison clinical pre-TPIAT liver MRI or ultrasound and insulin use and graft function data were extracted from the medical record. T-tests were used for the comparison of means across continuous variables between participants with and without post-TPIAT steatosis.
A total of 20 participants (mean: 13 ± 4 years; 12 female) were evaluated. Mean liver PDFF at research MRI was 7.4 ± 6.2% (range: 2-25%). Seven participants (35%) had categorical hepatic steatosis (PDFF>5%) post-TPIAT, five of whom had pre-TPIAT steatosis, reflecting a 13% (2/15; 95% CI: 2-40%) incidence of post-TPIAT steatosis. Participant characteristics were not significantly different between subgroups with and without post-TPIAT steatosis. Mean PDFF at research MRI was not different between graft function subgroups (7.5% optimal/good vs. 7.3% marginal/failure; p = .96).
Our study shows a moderate prevalence but low incidence of hepatic steatosis in a small sample of children and adolescents post-TPIAT. This study raises questions about a causal relationship between TPIAT and hepatic steatosis.
To define the frequency of post-TPIAT hepatic steatosis in a sample of children and adolescents and to identify clinical predictors of incident steatosis post-TPIAT.
In this prospective study, consecutive participants at least 1-month post-TPIAT underwent a liver MRI with proton density fat fraction (PDFF) and blood draw at our pediatric academic medical center between April 2021 and January 2022. Comparison clinical pre-TPIAT liver MRI or ultrasound and insulin use and graft function data were extracted from the medical record. T-tests were used for the comparison of means across continuous variables between participants with and without post-TPIAT steatosis.
A total of 20 participants (mean: 13 ± 4 years; 12 female) were evaluated. Mean liver PDFF at research MRI was 7.4 ± 6.2% (range: 2-25%). Seven participants (35%) had categorical hepatic steatosis (PDFF>5%) post-TPIAT, five of whom had pre-TPIAT steatosis, reflecting a 13% (2/15; 95% CI: 2-40%) incidence of post-TPIAT steatosis. Participant characteristics were not significantly different between subgroups with and without post-TPIAT steatosis. Mean PDFF at research MRI was not different between graft function subgroups (7.5% optimal/good vs. 7.3% marginal/failure; p = .96).
Our study shows a moderate prevalence but low incidence of hepatic steatosis in a small sample of children and adolescents post-TPIAT. This study raises questions about a causal relationship between TPIAT and hepatic steatosis.
摘要：
肝脏脂肪变性已被描述为成人全胰腺切除术伴胰岛自体移植（TPIAT）后的常见发现，但尚不清楚这种情况是否发生在儿童和青少年中。
定义儿童和青少年样本中TPIAT后肝性脂肪变性的频率，并确定TPIAT后发生脂肪变性的临床预测因素。
在这项前瞻性研究中，在2021年4月至2022年1月期间,TPIAT治疗后至少1个月的连续参与者在我们的儿科学术医学中心接受了带有质子密度脂肪分数(PDFF)和抽血的肝脏MRI检查.比较TPIAT前的临床肝脏MRI或超声检查以及从病历中提取的胰岛素使用和移植物功能数据。T检验用于比较有和没有TPIAT后脂肪变性的参与者之间连续变量的均值。
总共对20名参与者（平均：13±4岁；12名女性）进行了评估。研究MRI的平均肝脏PDFF为7.4±6.2％（范围：2-25％）。7名参与者（35％）在TPIAT后患有分类肝脂肪变性（PDFF>5％），其中五人患有TPIAT前脂肪变性，反映了13%(2/15;95%CI:2-40%)的TPIAT后脂肪变性的发生率。有和没有TPIAT后脂肪变性的亚组之间的参与者特征没有显着差异。研究中MRI的平均PDFF在移植物功能亚组之间没有差异（7.5％最佳/良好与7.3%边际/故障；p=.96）。
我们的研究表明，在TPIAT后的一小部分儿童和青少年中，肝脏脂肪变性的患病率中等，但发病率较低。这项研究提出了关于TPIAT和肝性脂肪变性之间因果关系的问题。
定义儿童和青少年样本中TPIAT后肝性脂肪变性的频率，并确定TPIAT后发生脂肪变性的临床预测因素。
在这项前瞻性研究中，在2021年4月至2022年1月期间,TPIAT治疗后至少1个月的连续参与者在我们的儿科学术医学中心接受了带有质子密度脂肪分数(PDFF)和抽血的肝脏MRI检查.比较TPIAT前的临床肝脏MRI或超声检查以及从病历中提取的胰岛素使用和移植物功能数据。T检验用于比较有和没有TPIAT后脂肪变性的参与者之间连续变量的均值。
总共对20名参与者（平均：13±4岁；12名女性）进行了评估。研究MRI的平均肝脏PDFF为7.4±6.2％（范围：2-25％）。7名参与者（35％）在TPIAT后患有分类肝脂肪变性（PDFF>5％），其中五人患有TPIAT前脂肪变性，反映了13%(2/15;95%CI:2-40%)的TPIAT后脂肪变性的发生率。有和没有TPIAT后脂肪变性的亚组之间的参与者特征没有显着差异。研究中MRI的平均PDFF在移植物功能亚组之间没有差异（7.5％最佳/良好与7.3%边际/故障；p=.96）。
我们的研究表明，在TPIAT后的一小部分儿童和青少年中，肝脏脂肪变性的患病率中等，但发病率较低。这项研究提出了关于TPIAT和肝性脂肪变性之间因果关系的问题。
