Abstract：
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) occurs in 10% to 40% of patients after pancreatic resection. Pancreatic exocrine insufficiency (PEI) is thought to be closely associated with NAFLD; however, the mechanism of NAFLD is not clearly understood. We perform a systematic review and meta-analysis to better understand the risk factors of NAFLD.
METHODS: A systematic literature search was performed in the MEDLINE database. Studies focused on the risk factors associated with NAFLD in patients undergoing pancreatectomy. The odds ratios (ORs) denoting the association of risk factors with NAFLD after resection were curated.
RESULTS: Of 814 published articles, 26 studies met the inclusion criteria. Combined, these studies included clinical data on 4055 patients. The pooled incidence of NAFLD was 29% (23%-35%). Among the various risk factors analyzed, the following had a significant likelihood of NAFLD on forest plot analysis: female gender (OR, 2.44), pancreatic ductal adenocarcinoma (OR, 2.11), portal vein or superior mesenteric vein resection (OR, 1.99), dissection of nerve plexus around the superior mesenteric artery (OR, 1.93), and adjuvant chemotherapy (OR, 1.58). Only 2 studies investigated 2 different measurements of quantitative PEI, which could not be used for analysis. Owing to heterogeneity of studies, pancreatic remanent volume, which is considered a marker for PEI could not be evaluated. Pancreatic enzyme replacement therapy (PERT) was not associated with NAFLD.
CONCLUSIONS: Numerous factors are associated with NAFLD after pancreatectomy. Previous research shows that PEI may be associated with NAFLD; however, this could not be compared in our meta-analysis. Further research is required to study the role of PERT in NAFLD.
METHODS: A systematic literature search was performed in the MEDLINE database. Studies focused on the risk factors associated with NAFLD in patients undergoing pancreatectomy. The odds ratios (ORs) denoting the association of risk factors with NAFLD after resection were curated.
RESULTS: Of 814 published articles, 26 studies met the inclusion criteria. Combined, these studies included clinical data on 4055 patients. The pooled incidence of NAFLD was 29% (23%-35%). Among the various risk factors analyzed, the following had a significant likelihood of NAFLD on forest plot analysis: female gender (OR, 2.44), pancreatic ductal adenocarcinoma (OR, 2.11), portal vein or superior mesenteric vein resection (OR, 1.99), dissection of nerve plexus around the superior mesenteric artery (OR, 1.93), and adjuvant chemotherapy (OR, 1.58). Only 2 studies investigated 2 different measurements of quantitative PEI, which could not be used for analysis. Owing to heterogeneity of studies, pancreatic remanent volume, which is considered a marker for PEI could not be evaluated. Pancreatic enzyme replacement therapy (PERT) was not associated with NAFLD.
CONCLUSIONS: Numerous factors are associated with NAFLD after pancreatectomy. Previous research shows that PEI may be associated with NAFLD; however, this could not be compared in our meta-analysis. Further research is required to study the role of PERT in NAFLD.
摘要：
背景：非酒精性脂肪性肝病（NAFLD）发生在10-40％的患者胰腺切除术后。胰腺外分泌功能不全（PEI）被认为与NAFLD密切相关，但NAFLD的发病机制尚不清楚.我们进行了系统评价和荟萃分析，以更好地了解NAFLD的危险因素。
方法：在Medline数据库中进行了系统的文献检索。研究集中在接受胰腺切除术的患者中与NAFLD相关的危险因素。显示切除后危险因素与NAFLD关联的比值比（OR）。
结果：在已发表的814篇文章中，26项研究符合纳入标准。合并,这些研究包括4055例患者的临床数据.合并的NAFLD发生率为29%（23%-35%）。在分析的各种风险因素中，以下在森林地块分析中具有NAFLD的显着可能性：女性（OR=2.44），胰腺导管腺癌（OR=2.11），门静脉或肠系膜上静脉切除术（OR=1.99），肠系膜上动脉周围神经丛夹层（OR=1.93），辅助化疗(OR=1.58)。只有两项研究调查了定量PEI的两种不同测量，不能用于分析。由于研究的异质性，胰腺剩余体积，无法评估被认为是PEI的标志物。胰酶替代疗法（PERT）与NAFLD无关。
结论：许多因素与胰腺切除术后的NAFLD相关。先前的研究表明，PEI可能与NAFLD有关，然而,这在我们的荟萃分析中无法比较.需要进一步的研究来研究PERT在NAFLD中的作用。
方法：在Medline数据库中进行了系统的文献检索。研究集中在接受胰腺切除术的患者中与NAFLD相关的危险因素。显示切除后危险因素与NAFLD关联的比值比（OR）。
结果：在已发表的814篇文章中，26项研究符合纳入标准。合并,这些研究包括4055例患者的临床数据.合并的NAFLD发生率为29%（23%-35%）。在分析的各种风险因素中，以下在森林地块分析中具有NAFLD的显着可能性：女性（OR=2.44），胰腺导管腺癌（OR=2.11），门静脉或肠系膜上静脉切除术（OR=1.99），肠系膜上动脉周围神经丛夹层（OR=1.93），辅助化疗(OR=1.58)。只有两项研究调查了定量PEI的两种不同测量，不能用于分析。由于研究的异质性，胰腺剩余体积，无法评估被认为是PEI的标志物。胰酶替代疗法（PERT）与NAFLD无关。
结论：许多因素与胰腺切除术后的NAFLD相关。先前的研究表明，PEI可能与NAFLD有关，然而,这在我们的荟萃分析中无法比较.需要进一步的研究来研究PERT在NAFLD中的作用。
