Korelasi antara Visceral Fat Adiposity/Subcutaneous Fat Adiposity ratio dengan Pancreatic Steatosis pada Pasien diabetes Melitus Tipe 2
Bernadin Rexy Apriandi Wijaya, Prof. Dr. dr. Lina Choridah, Sp.Rad(K)PRP, dr. Sri Retna Dwidanarti, Sp. Rad., Subsp.Onk.(K)
2026 | Tesis | S2 Kedokteran Klinik
Latar Belakang: Adipositas viseral berperan penting dalam patofisiologi diabetes melitus tipe 2 (DMT2) dan diduga berhubungan dengan deposisi lemak ektopik, termasuk pancreatic steatosis. Meskipun lemak viseral sering dikaitkan dengan pancreatic steatosis hubungan antara pancreatic steatosis dan rasio visceral fat adiposity terhadap subcutaneous fat adiposity (VAT/SAT ratio) pada pasien DMT2 masih belum jelas.
Tujuan: Menilai korelasi antara VAT/SAT ratio dan pancreatic steatosis pada pasien DMT2 menggunakan computed tomography (CT).
Metode: Penelitian ini merupakan studi retrospective cross-sectional pada pasien DMT2 yang menjalani CT abdomen periode Januari 2023–September 2025. Luas lemak viseral dan subkutan diukur secara semi-automatis pada CT non-kontras setinggi umbilikus untuk menghitung VAT/SAT ratio. Pancreatic steatosis dinilai berdasarkan selisih atenuasi parenkim pankreas terhadap lien pada CT non-kontras. Analisis korelasi, korelasi parsial, dan regresi multivariat dilakukan dengan mempertimbangkan variabel perancu.
Hasil: Sebanyak 43 subjek dianalisis dengan median VAT/SAT ratio 0,57 (0,23–2,68) dan rerata selisih atenuasi pankreas–lien ?7,36 ± 6,39 HU. Tidak ditemukan korelasi bermakna antara VAT/SAT ratio dan pancreatic steatosis (r = ?0,081; p = 0,607). Korelasi antara pancreatic steatosis dengan visceral fat, subcutaneous fat, dan total fat juga tidak signifikan (p > 0,05). Analisis multivariat menunjukkan bahwa VAT/SAT ratio bukan prediktor independen pancreatic steatosis setelah kontrol variabel perancu (p = 0,641).
Kesimpulan: VAT/SAT ratio tidak berhubungan secara signifikan dengan pancreatic steatosis pada pasien DMT2. Temuan ini menunjukkan bahwa akumulasi lemak pankreas bersifat multifaktorial dan tidak semata-mata ditentukan oleh distribusi lemak abdominal.
Background: Visceral adiposity plays a key role in the pathophysiology of type 2 diabetes mellitus (T2DM) and has been implicated in ectopic fat deposition, including pancreatic steatosis. However, the association between pancreatic steatosis and the visceral fat adiposity/subcutaneous fat adiposity (VAT/SAT) ratio in patients with T2DM remains unclear.
Objective: To evaluate the correlation between the VAT/SAT ratio and pancreatic steatosis in patients with T2DM using computed tomography (CT).
Methods: This retrospective cross-sectional study included patients with T2DM who underwent abdominal CT between January 2023 and September 2025. Visceral and subcutaneous fat areas were quantified semi-automatically on non-contrast axial CT images at the umbilical level to calculate the VAT/SAT ratio. Pancreatic steatosis was assessed by measuring the attenuation difference between the pancreas and spleen on non-contrast CT using region-of-interest analysis. Correlation, partial correlation, and multivariate regression analyses were performed to adjust for potential confounding variables.
Results: Forty-three subjects were analyzed, with a median VAT/SAT ratio of 0.57 (0.23–2.68) and a mean pancreatic–splenic attenuation difference of ?7.36 ± 6.39 HU. No significant correlation was observed between the VAT/SAT ratio and pancreatic steatosis (r = ?0.081; p = 0.607). Pancreatic steatosis was also not significantly correlated with visceral, subcutaneous, or total fat (p > 0.05). Multivariate analysis confirmed that the VAT/SAT ratio was not an independent predictor of pancreatic steatosis (p = 0.641).
Conclusion: In patients with T2DM, the VAT/SAT ratio was not significantly associated with pancreatic steatosis. These findings suggest that pancreatic fat accumulation is influenced by multifactorial mechanisms beyond abdominal fat distribution alone.
Kata Kunci : pancreatic steatosis, VAT/SAT ratio, visceral fat, computed tomography, type 2 diabetes mellitus
