Background: Pancreatic fat is believed to be associated with an increased risk to develop type 2 Diabetes, fatty liver disease and cardiovascular disease, but the clinical effects of pancreatic fat accumulation are poorly understood. Magnetic resonance imaging can be used to quantify fat in different body compartments to gain understanding of metabolic risk associations.

Objectives: The aim of this study was to investigate if pancreatic fat can be used as a biomarker for metabolic co-morbidities such as type 2 Diabetes and coronary heart disease as well as metabolic health.

Method: This study included images from the first 4 5 2 3 participants scanned by UK Biobank. Pancreatic fat was measured in three regions of interest of varying size that were placed on the head, body and tail of the pancreas. Associations between pancreatic fat and metabolic status were determined using multivariate statistical modelling.

Results: Multivariate linear regression models showed that visceral adipose tissue is the strongest predictor for pancreatic fat (p < 0.01). Multivariate logistic regression analyses showed unique associations between pancreatic fat and type 2 Diabetes, coronary heart disease and absence of metabolic health (p < 0.01). These associations could not be described by sex, age, lifestyle factors, medications, other fat compartments or BMI.

Conclusion: MRI determined pancreatic fat has the potential to be used as a biomarker for metabolic co - morbidities such as type 2 Diabetes and coronary heart disease as well as metabolic health.