Clinical Medicine and Diagnostics 2015, 5(3): 35-38 DOI: 10.5923/j.cmd.20150503.01 A Retrospective Study of Pancreatic Lipomatosis and Its Association with Diabetes Mellitus in General Population in North India Rajesh Sharma 1 , Manjit Arora 1 , Puneet Gupta 1,* , Manik Mahajan 2 , Rattan Paul 1 , Poonam Sharma 3 1 Department of Radio-diagnosis and Imaging, ASCOMS Hospital, Jammu University, Jammu, J&K, India 2 Department of Radio-diagnosis and Imaging, PGIMS, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, India 3 Department of Pathology, GMC Hospital, Jammu University, Jammu, J&K, India Abstract Background/ Introduction: Fatty replacement is a common condition involving the pancreas. Small focal fatty deposits in pancreas are relatively insignificant; however, excessive fat deposition has a pathologic significance and is commonly associated with marked reduction in exocrine function of pancreas. A few studies have investigated the relationship between pancreatic lipomatosis and diabetes mellitus but no such study has been carried out in India according to best of our knowledge. So the objective of this study was to evaluate the incidence of pancreatic lipomatosis in north India and to determine its association with diabetes mellitus. Material and Methods: Multi-Detector Computed Tomography (MDCT) scans of 270 patients who underwent abdominal examination during a period of 2 years at a tertiary care centre in north-west India were retrospectively reviewed. Pancreatic lipomatosis was evaluated in all the patients and their association with diabetes mellitus was analyzed. Results: Among 270 patients, 155 were males & 115 were females. Pancreatic lipomatosis was seen in 8 patients (2.96% cases), even type in 2 and uneven type in 6 cases. In 4 out of 6 (66.7%) patients, the uneven fatty infiltration was of type 1 while in 2 out of 6 (33.3%) patients, type 2 pancreatic lipomatosis was seen. Diabetes mellitus was seen in 14 patients out of 270. Pancreatic lipomatosis was seen in 6 out of 14 diabetic patients (42.8%). Significant correlation was established between pancreatic lipomatosis and diabetes mellitus (p<0.0001). Conclusion: Pancreatic lipomatosis is often an asymptomatic and incidental finding in MDCT seen in 2.96 % cases and significant correlation exists between pancreatic lipomatosis and diabetes mellitus. Keywords Computed tomography, Diabetes mellitus, Pancreas, Lipomatosis 1. Introduction The pancreas is an exocrine and endocrine organ approximately 15-20 cm long that is related to the stomach, duodenum, colon, and spleen. Fatty degeneration of the pancreas is common with aging; the entire pancreas may be replaced by fat, and the patient may have no clinical symptoms. Fatty replacement of exocrine pancreas, also known as fatty infiltration, lipomatosis, adipose atrophy, or lipomatous pseudohypertrophy is a well-documented benign entity of speculative origin [1]. The exact etiopathogenesis behind fatty replacement is not known; however, several predisposing factors have been suggested. These include obesity, diabetes mellitus, chronic pancreatitis, hereditary pancreatitis, pancreatic duct obstruction by calculus or tumor, and cystic fibrosis [2]. * Corresponding author: puneetgupta619@yahoo.com (Puneet Gupta) Published online at http://journal.sapub.org/cmd Copyright © 2015 Scientific & Academic Publishing. All Rights Reserved Fatty replacement may be focal or diffuse. Focal fatty replacement is the commonest degenerative lesion of pancreas and has no major clinical significance. Total fat replacement is a rare condition and is associated with pancreatic enzyme deficiency and malabsorption. Following are few subtypes: ● Even pancreatic lipomatosis ● Uneven pancreatic lipomatosis There are four different types of uneven pancreatic lipomatosis. Type 1a (35% of cases) is characterized by replacement of the head with sparing of the uncinate process and peribiliary region; type 1b (36%), by replacement of the head, neck, and body, with sparing of the uncinate process and peribiliary region; type 2a (12%), by replacement of the head, including the uncinate process, and sparing of the peribiliary region; and type 2b (18%), by total replacement of the pancreas with sparing of the peribiliary region [3]. Progressive B-cell dysfunction, in the context of insulin resistance, is a hallmark of type 2 diabetes [4]. Glucose toxicity, ensuing from diabetes related hyperglycemia, has been regarded as a contributor to B-cell damage [5]. In