Higher fat content in the pancreas of children and adolescents with obesity is associated with an increased level of heart 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 (12-15 May).
The study, led by clinicians and researchers from The Children’s Obesity Clinic, Centre for Obesity Management, Holbæk University Hospital in Denmark is one of the first to explore the role of a fatty pancreas on young people’s cardiometabolic health.
“Our study underscores the need to treat pancreatic fat content in young people far more seriously, as it is likely related to developing a range of leading heart and metabolic health risks, making it a critical area for early detection and obesity management,” said senior author head consultant Jens-Christian Holm from the Copenhagen University Hospital Holbæk in Denmark.
In 2020, an estimated 25 million children and 35 million adolescents were living with metabolic syndrome worldwide—a cluster of the most dangerous risk factors for cardiovascular disease and type 2 diabetes, including abdominal obesity, high cholesterol, high blood pressure, and raised fasting plasma glucose [1].
In obesity, the adipose tissue expands and can spill over to other organs including the pancreas, skeletal muscle and liver. In adults, higher levels of pancreatic fat are strongly associated with serious health concerns including metabolic syndrome, type 2 diabetes and high blood pressure. However, evidence for this association with cardiometabolic health among children and adolescents with obesity is limited.
To investigate these knowledge gaps, Danish researchers set out to quantify pancreatic fat content in children and adolescents with obesity and to evaluate its association to general and local fat deposition and other cardiometabolic risk factors, including waist and hip circumference, fasting plasma glucose, low- and high-density lipoprotein (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 medical imaging technique known as magnetic resonance spectroscopy to measure the amount of fat in in the pancreas, liver, and abdomen of 283 young people (aged 7-19-year-olds; 49% female) referred for obesity treatment at The Children’s Obesity Clinic, Center of Management, Holbæk University Hospital, during their first visit between February 2020 and September 2025. All participants also underwent physical measurements (e.g., height, weight, blood pressure) and extensive clinical evaluations.
In their analysis, the researchers controlled for age and sex 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 levels of C-peptide (a marker of insulin resistance)—all key factors in increasing cardiometabolic-related health risks.
In contrast, the study did not substantiate associations between pancreatic fat percentage and systolic blood pressure, fasting insulin and HOMA-IR (measures of insulin resistance), fasting glucose, alanine aminotransferase (ALT, a marker of liver function), or LDL-, HDL- or total cholesterol.
“These are early results, but measuring pancreatic fat content could be valuable to identify the children and adolescents who are most likely to develop cardiometabolic risks, and thus in need of intensified treatment," said Dr Holm. “The next step is to determine whether reducing the amount of fat in the pancreas also lowers cardiometabolic risk.”
The authors acknowledge several limitations to the study, including that the study is cross-sectional in design and cannot establish causal relationships, and is potentially subject to confounding and reverse causation errors. Additionally, they note that the study includes mainly European Caucasian children and adolescents making the generalisability of the findings to other ethnicities less certain, and a larger obesity management study could confirm and extend the study results.
31-Mar-2026
The authors declare no conflicts of interest.