الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Excessive obesity, especially central/visceral obesity can lead to adipose tissue accumulation in the body and adipose tissue deposited in certain organs such as the liver, pancreas, and heart, is defined as “ectopic fat deposition”.
Fatty pancreas is characterized by excessive fat deposition and this condition was first reported by Ogilvie in 1993. It is also known as padiposity, fatty replacement of pancreas, pancreatic steatosis, fatty infiltration of the pancreas, nonalcoholic fatty pancreas disease (NAFPD), lipomatous atrophy of the pancreas, pancreatic lipomatosis and pancreatic. Pancreas adiposis is best defined in magnetic resonance imaging (MRI), computed tomography (CT) and endoscopic ultrasonography (EUS) but it is expensive and usually used in academic settings only.
Hence, there is a need for identification of biological markers of pancreatic fat that are accurate, inexpensive, and convenient for early diagnosis of individuals at increased risk of developing metabolic disorders. So we will study the role of lipocalin-2 as potential non-invasive biomarker in fatty pancreas and relation between fatty pancreas and NAFLD.
Lipocalin-2 (LCN-2) is a glycoprotein that belongs to the lipocalin super family of small molecular lipid chaperones. Initially thought to be only a bacteriostatic factor secreted by activated neutrophils at sites of infection it was subsequently shown to be expressed by various cell types including but not limited to adipocytes, macrophages and hepatocytes. Lipocalin-2 was investigated as a biomarker of various diseases, such as cardiovascular disorders, ulcerative colitis and chronic renal diseases. Moreover, increased circulating levels of LCN-2 were observed in type 2 diabetes, obesity and diseases of the exocrine pancreas including pancreatitis and pancreatic cancer.
The aim is to study the relationship between fatty pancreas, NAFLD and metabolic syndrome Secondary aim is to study lipocalin-2 as a non-invasive marker of the diagnosis fatty pancreas.
This Cross sectional clinical study and this study will be performed on 60 Egyptian patients and 30 Egyptian healthy volunteers taken as control. All patients were taken Full history Full clinical examination Calculation of Body Mass Index Waist circumference Laboratory investigations including: Complete blood count, Liver function tests including: serum alanine aminotransferase and aspartate aminotransferase, total & direct bilirubin, serum albumin. Gamma-glutamyl transferase (GGT) Serum creatinine HBsAg–HCV Ab–HIV Ab S. lipase Prothrombin time and INR Serum fasting blood glucose 2 hour post prandial blood sugar Lipid Profile ANA( IgG) Serum lipocalin-2 Imaging: trans-abdominal US compare the echogenicity of the liver, spleen, renal parenchyma, the adipose tissue within the area of the superior mesenteric artery with pancreatic tissues characteristics of ultrasonic image of fatty pancreas (Full shape, blurred edges, normal or slightly increased volume, A similar or slightly higher echogenicity liver, spleen, renal parenchyma and to the adipose tissue in the area of the superior mesenteric artery) Fatty liver index is calculated using special formula to support the diagnosis of fatty liver and the referral of suspected patients to ultrasonography based on patient BMI (from weight and height measurements), waist circumference, serum triglyceride and gamma-glutamyl-transferase levels. NAFLD fibrosis score (NFS): will be done for diagnosis of hepatic fibrosis on top of NAFLD.
The waist circumference, body mass index, weight, serum triglyceride and serum cholesterol were significantly higher in NAFPD and NAFLD patients than healthy controls.in contrast serum lipocalin was higher in NAFPD patients than in healthy controls and NAFLD patients. And this mean serum lipocalin used diagnostic marker in NAFPD. On the other hand there was no statistical difference in serum ALT, AST, albumin GGT levels and fatty liver index between controlled group and NAFPD And NAFLD.
And present serum lipocalin was positively correlated with waist circumference, total cholesterol and triglycerides. Furthermore serum lipocalin cut-off (>600NG/L) it has a sensitivity 100% and specificity 96.67% this finding suggest that lipocalin used a diagnostic marker of NAFPD.