Fatty Liver and Pancreatic Steatosis in Patients with Chronic Hepatitis B and C and Wilson's Disease

Objectives: The aim of this study is to determine the presence of fatty liver and pancreatic steatosis in individuals diagnosed with Chronic Hepatitis B (CHB), Chronic Hepatitis C (CHC), and Wilson's Disease (WD) and to evaluate the relationship between the presence of fatty liver and pancreatic steatosis and laboratory parameters.
Methods: Forty-eight CHB, fifty-six CHC, and thirty-five WD patients were included in the study. Pancreatic steatosis was measured by three methods: steatosis according to the mean pancreas value, steatosis according to the pancreas/spleen difference value, and steatosis according to the pancreas/spleen density ratio. Hepatic steatosis was measured by noncontrast CT using multi-site attenuation sampling and the Liver Attenuation Index (LAI); steatosis was graded according to predefined LAI cut-offs. Fatty liver and pancreatic steatosis were graded as Grade 1, 2, or 3. Certain laboratory parameters of the patients were also retrospectively reviewed.
Results: In 69.1% of all patients, grade 1 fatty liver disease was present. Pancreatic steatosis was absent in 50.3% of patients ac-cording to the mean pancreas value, 63.3% according to the pancreas/spleen difference, and 61.9% according to the pancreas/spleen density ratio. Fatty liver disease was positively correlated with high Erythrocyte Sedimentation Rate (ESR) (r=0.255, p=0.002) and Alanine Transaminase (ALT) (r=0.180, p=0.034). ESR (p=0.025) and urea level (p=0.024) were found to be significantly higher in the group with steatosis according to the mean pancreas value. According to the group with steatosis based on the pancreas/spleen density ratio, globulin level was significantly higher (p=0.038). The rates of steatosis according to the pancreas mean value (p=0.003) and the pancreas/spleen density ratio (p=0.039) were significantly more advanced in CHC patients compared with the other patient groups. There was no statistically significant difference between the stage of fatty liver and the stage of fatty pancreas (p>0.05).
Conclusion: Although fatty liver and pancreatic steatosis are considered similar pathologies, our findings suggest that these two conditions should not be considered interchangeable. Further studies with larger samples may be useful to better demonstrate the correlation between the two conditions and the investigated parameters.

Keywords: Chronic Hepatitis B, Chronic hepatitis C, fatty liver, pancreatic steatosis, Wilson's disease