High fat content in the pancreas of obese children and adolescents is associated with increased levels of cardiovascular and metabolic risk factors, including higher than average body mass index (BMI), elevated diastolic blood pressure, higher levels of abdominal and liver fat, and insulin resistance, according to new research presented at this year’s European Congress on Obesity (ECO) in Istanbul, Turkey (May 12-15).
The study, led by physicians and researchers from The Children’s Obesity Clinic, Center for Obesity Management, Holbyck University Hospital in Denmark, is one of the first to explore the role of fatty pancreas on the cardiometabolic health of young people.
“Our study emphasizes the need to treat pancreatic fat content more seriously in young people, as it is associated with developing a range of major cardiovascular and metabolic health risks, making it an important area for early detection and management of obesity,” said lead author Jens-Christian Holm, a consultant from Copenhagen University Hospital Holbæk in Denmark.
In 2020, an estimated 25 million children and 35 million adolescents worldwide were living with metabolic syndrome – a cluster of the most dangerous risk factors for heart disease and type 2 diabetes, including abdominal obesity, high cholesterol, high blood pressure and elevated fasting plasma glucose.
In obesity, fat tissue expands and may spread to other organs, including the pancreas, skeletal muscle, and liver. In adults, high levels of pancreatic fat are linked to serious health concerns, including metabolic syndrome, type 2 diabetes, and high blood pressure. However, evidence for this association with cardiometabolic health in obese children and adolescents is limited.
To investigate these knowledge gaps, Danish researchers set out to quantify pancreatic fat content in obese children and adolescents and evaluate its association with general and local fat deposition and other cardiometabolic risk factors, including waist and hip circumferences, fasting plasma glucose, low- and high-density lipoproteins (LDL and HDL) and total cholesterol, liver function, insulin resistance, and systolic and diastolic blood pressure.
For the study, researchers used a safe, non-invasive method called magnetic resonance spectroscopy to measure the amount of fat in the pancreas, liver and abdomen of 283 young people (aged 7-19 years; 49% female) referred for obesity treatment at The Children’s Obesity Clinic, Center of Management, Holbeck University Hospital, during their first visit between February 2020 and September 2025. Used medical imaging techniques. All participants also underwent physical measurements (e.g., height, weight, blood pressure) and comprehensive clinical evaluation.
In their analysis, the researchers controlled for age and gender to rule out the influence of those factors.
The analysis found that in young people with severe obesity, higher pancreatic fat levels were associated with higher-than-average BMI, waist-to-height ratio, diastolic blood pressure, liver and visceral fat content and C-peptide (a marker of insulin resistance) levels – all of which are key factors in increasing cardiometabolic-related health risks.
In contrast, the study did not confirm an association between pancreatic fat percentage and systolic blood pressure, fasting insulin and HOMA-IR (a measure of insulin resistance), fasting glucose, alanine aminotransferase (ALT, a marker of liver function), or LDL-, HDL- or total cholesterol.
“These are preliminary results, but measuring the fat content of the pancreas may be valuable for identifying children and adolescents who are most likely to develop cardiometabolic risk, and therefore need intensive treatment,” Dr. Holm said.
The next step is to determine whether reducing fat content in the pancreas also reduces cardiometabolic risk.”
Jens-Christian Holm, Copenhagen University Hospital Holbæk
The authors acknowledge several limitations of the study, including that the study is cross-sectional in design and cannot establish causal relationships, and is potentially subject to confounding and reverse causality errors. Additionally, they note that the study included primarily European Caucasian children and adolescents, making the generalizability of the findings to other ethnicities less certain, and that a larger obesity management study could confirm and extend the study’s results.
