Excess Liver Fat in Type 2 Diabetes Stratified by Intrapancreatic Fat Deposition: A Meta‐Analysis of Dual‐Organ MRI Studies

ABSTRACT

Both liver fat content (LFC) and intrapancreatic fat deposition (IPFD) are frequently increased in Type 2 diabetes mellitus (T2DM). We meta‐analysed dual‐organ MRI studies comparing LFC between individuals with T2DM and non‐diabetic controls and explored whether study‐level differences in LFC varied according to IPFD burden. Seventeen studies (2142 participants) were included. Individuals with T2DM had significantly higher LFC than non‐diabetic controls (standardised mean difference [SMD] 0.89, 95% CI 0.60–1.18). In exploratory subgroup analyses, liver fat excess was larger in studies with mean IPFD ≥ 10% than in those with IPFD < 10% (SMD 1.20 vs. 0.62; p  = 0.04), though this finding was not consistently retained in leave‐one‐out analyses. Alternative IPFD cutoffs yielded directionally similar but non‐significant subgroup differences. Study‐level differences in IPFD were associated with differences in LFC ( β  = 0.383, p  = 0.006) in univariable meta‐regression, but not after BMI adjustment. These findings suggest that higher IPFD is associated with greater liver fat excess in T2DM at the study level. Individual‐level analyses are now warranted to clarify this relationship.