Matheus Souza

@ufrj
Interest in liver/GI, physics, soccer and music.
Learner

[Matheus Souza @mhenrique028]

New from us in Current Obesity Reports!
https://t.co/V7QPngZw0f

Lifestyle change reaches the pancreas too. In our synthesis, diet and exercise significantly reduced intrapancreatic fat deposition, with the largest numerical effect observed when combined.

#GITwitter #MedTwitter

[Hernandez Edgar @Internistacl]

📍𝐌𝐚𝐫𝐜𝐨 𝐂𝐨𝐧𝐜𝐞𝐩𝐭𝐮𝐚𝐥 𝐲 𝐆𝐮𝐢́𝐚 𝐝𝐞 𝐄𝐱𝐩𝐞𝐫𝐭𝐨𝐬 𝐬𝐨𝐛𝐫𝐞 𝐞𝐥 𝐃𝐞𝐩𝐨́𝐬𝐢𝐭𝐨 𝐝𝐞 𝐆𝐫𝐚𝐬𝐚 𝐈𝐧𝐭𝐫𝐚𝐩𝐚𝐧𝐜𝐫𝐞𝐚́𝐭𝐢𝐜𝐚: 𝐄𝐥 𝐂𝐨𝐧𝐬𝐞𝐧𝐬𝐨 𝐝𝐞 𝐌𝐞𝐥𝐛𝐨𝐮𝐫𝐧𝐞 (Nature Reviews Gastroenterology & Hepatology | 2026)

🕒 𝗣𝗼𝗯𝗹𝗮𝗰𝗶𝗼́𝗻: Proceso Delphi modificado en 2 rondas con 25 expertos clave (8 disciplinas, 15 países, 6 continentes) y 183 miembros colaboradores de la Alianza Global de Grasa Intrapancreática (GIFT, por sus siglas en inglés: Global Intrapancreatic FaT Alliance). Se evaluaron revisiones sistemáticas e investigaciones previas con cohortes prospectivas y meta-análisis que abarcan más de 100000 participantes (n > 100000).

📈 𝗣𝗲𝗿𝗹𝗮𝘀 𝗖𝗹𝗶́𝗻𝗶𝗰𝗮𝘀:

• Prevalencia poblacional: Un meta-análisis de 100000 participantes muestra que aproximadamente 1 de cada 5 adultos (20 por ciento) presenta Depósito de Grasa Intrapancreática (IPFD, por sus siglas en inglés: Intrapancreatic Fat Deposition) excesivo.

• Riesgo de pancreatitis aguda: El Trastorno de Páncreas Graso (FPD, por sus siglas en inglés: Fatty Pancreas Disorder) eleva 3.9 veces el riesgo de pancreatitis aguda en cohortes prospectivas generales (p < 0.01).

• Causalidad genética en pancreatitis: Un análisis de Aleatorización Mendeliana confirmó que cada aumento de 1 desviación estándar en IPFD incrementa el riesgo de pancreatitis aguda en 1.4 veces y de pancreatitis crónica en 1.6 veces (Intervalo de Confianza del 95 por ciento [IC 95%], p < 0.01).

• Pancreatitis post-ERCP: El FPD detectado en Tomografía Computarizada (TC) previa al procedimiento aumenta el riesgo de pancreatitis post Colangiopancreatografía Retrógrada Endoscópica (ERCP) en 3.7 veces.

• Cáncer pancreático esporádico: Meta-análisis de 23 estudios muestra una probabilidad 3.2 veces mayor de FPD en cáncer de páncreas; la Aleatorización Mendeliana demuestra una Razón de Riesgo Intertemporal (HR, por sus siglas en inglés: Hazard Ratio) de 1.5 por cada incremento de 1 desviación estándar en IPFD (p < 0.01).

• Precursor tumoral IPMN: En pacientes con Neoplasia Mucinosa Papilar Intraductal (IPMN, por sus siglas en inglés), el FPD al inicio incrementa 4.6 veces el riesgo de desarrollar Adenocarcinoma Ductal Pancreático (PDAC) concomitante a 12 años de seguimiento.

• Diabetes Mellitus Tipo 2 (DM2): El FPD incrementa el riesgo de DM2 incidente en un 81 por ciento a 11.1 años; cada aumento del 1 por ciento en IPFD eleva el riesgo de diabetes en un 7 por ciento.

• Cirugía bariátrica metabólica: Logra una reducción absoluta de IPFD del 3.9 por ciento a los 3 meses, alcanzando una reducción del 42 por ciento en la frecuencia de diabetes (p < 0.01).

• Respuesta farmacológica: Meta-análisis de 8 ensayos clínicos aleatorizados demuestra que los Agonistas del Receptor del Péptido Similar al Glucagón tipo 1 (GLP-1 RA) reducen el IPFD en 1.6 por ciento y los Inhibidores del Cotransportador de Sodio-Glucosa tipo 2 (SGLT2i) en 1.4 por ciento (p < 0.01).

• Inexactitud de ultrasonido: La Ultrasonografía Endoscópica (USE) presenta una discrepancia del 94 por ciento al compararse con la Resonancia Magnética (IRM, por sus siglas en inglés: Magnetic Resonance Imaging), clasificando erróneamente al 79-94 por ciento de los sujetos.

📉 𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼́𝗻: El FPD representa un estado patológico temprano, independiente de la obesidad general, medible de forma precisa mediante IRM cuantitativa y con alto impacto causal en pancreatitis, DM2 y cáncer de páncreas. Su reversión mediante dieta, ejercicio, GLP-1 RA, SGLT2i o cirugía bariátrica constituye un pilar para la prevención primaria y terciaria de enfermedades pancreáticas.

🔗 𝗗𝗢𝗜: https://t.co/lec0lpWyCq

#Pancreas #Gastroenterologia #Endocrinologia #Medicina #Internista

[CME INDIA @CMEINDIA1]

Fatty Pancreas Disorder (FPD): The Melbourne Consensus 2026

The first international consensus defining fatty pancreas as a distinct disease entity.

🔹 The One-Line Message

Not all fatty pancreas is innocent. Excess intrapancreatic fat is now recognized as a distinct pathological condition—Fatty Pancreas Disorder (FPD)—with important implications for diabetes, pancreatitis, and pancreatic cancer.

📌 What is Fatty Pancreas Disorder?

- FPD is a pathological state characterized by excessive intrapancreatic fat deposition (IPFD) that increases the risk of adverse health outcomes.
- It is not merely an incidental imaging finding and should be considered an organ-specific disease process.

---

🔬 What Constitutes Intrapancreatic Fat?

- IPFD comprises:
- Intrapancreatic adipocytes
- Lipid-rich inclusions within pancreatic cells
- Focal fat masses are excluded from the definition.

⚠️ Important Clinical Concepts

- A small amount of pancreatic fat is physiological.
- Pancreatic fat can increase:
- Without weight gain
- Without fatty liver
- Therefore, pancreatic steatosis should not be viewed simply as an extension of MASLD.

---

🩺 Two Distinct Types of FPD

Type 1 FPD

- Excess pancreatic fat without excess body fat
- Suggests mechanisms beyond obesity.

Type 2 FPD

- Excess pancreatic fat associated with excess body fat
- Reflects obesity-related pancreatic fat accumulation.

This classification may help personalize prevention and future therapeutic strategies.

---

🎯 Why Does It Matter?

FPD is associated with an increased risk of:

- Type 2 diabetes mellitus
- Acute and chronic pancreatitis
- Pancreatic cancer
- Exocrine pancreatic dysfunction
- Other pancreatic disorders under active investigation

---

🖥️ How Should We Diagnose It?

✅ MRI with voxel-wise fat quantification is the preferred diagnostic modality.

❌ Conventional endoscopic ultrasonography (EUS) should NOT be used to diagnose FPD, despite its widespread availability.

💡 Pathogenesis

- FPD usually reflects cumulative lifetime pancreatic insults rather than a single identifiable cause.
- The emphasis shifts from identifying one cause to understanding overall pancreatic fat burden and long-term risk.

⭐ Clinical Take-Home Messages

- Fatty pancreas is now a defined disease entity, not merely a radiological curiosity.
- Pancreatic fat should be evaluated independently of liver fat.
- MRI is the current gold standard for diagnosis.
- Recognition of FPD may improve risk stratification for diabetes, pancreatitis, and pancreatic cancer.
- Future research will determine whether reducing pancreatic fat translates into better clinical outcomes.

📚 Reference

The Melbourne Consensus on Fatty Pancreas Disorder (FPD). Nature Reviews Gastroenterology & Hepatology. 2026.

Article:
https://t.co/sjVVa33kCh

[Grace Wong @wonglaihung]

I am so proud of my girls! ☺️☺️☺️
Full text▶️ https://t.co/rvBk3M349Y
#DM #HbA1cTrajectory #LRE
@JHepatology @CUHKMedicine @CUHKGI

[Scott Isaacs @scottisaacsmd]

Fatty pancreas disorder is classified into type 1 (without obesity) and type 2 (with obesity), both representing an early organ-specific state that reshapes the pancreatic secretome and cellular architecture and can drive pancreatitis, diabetes and pancreatic cancer.
https://t.co/pk3xmTMT4t

[Walter Suárez Carmona @a_fisiolog57853]

Consenso que establece un marco conceptual integral y guía sobre la acumulación de grasa intrapancreática y los desórdenes que la acompañan.

¡¡¡A leer, zagales!!!

Link en mi bio

o

https://t.co/w96Cn3SaZ2

[Scott Isaacs @scottisaacsmd]

Fatty pancreas disorder is now defined as a distinct, organ-specific pathological state of excessive intrapancreatic fat that raises the risk of pancreatitis, pancreatic cancer and multiple forms of diabetes, best diagnosed with MRI.
https://t.co/B6p6n5rt5s

[Matheus Souza @mhenrique028]

Proud of this team effort with Saeed, Stella, @PojsakornDan, and Max

[Matheus Souza @mhenrique028]

New from us in Current Obesity Reports!
https://t.co/V7QPngZw0f

Lifestyle change reaches the pancreas too. In our synthesis, diet and exercise significantly reduced intrapancreatic fat deposition, with the largest numerical effect observed when combined.

#GITwitter #MedTwitter

[Matheus Souza @mhenrique028]

@NatRevGastroHep Link: https://t.co/np9R9Eppez

[Matheus Souza @mhenrique028]

Just out in @NatRevGastroHep!
Time to adjust the ROIs and place the pancreas at the center of the ectopic fat conversation.

The Melbourne consensus advances how intrapancreatic fat deposition is defined, measured, and interpreted.

#GITwitter #MedTwitter

[Nature Reviews Gastroenterology & Hepatology @NatRevGastroHep]

New online! Conceptual framework and expert guidance on intrapancreatic fat deposition: the Melbourne consensus https://t.co/SR7KlseOYz

[Matheus Souza @mhenrique028]

@BlaneyMD Thank you so much !!

[Matheus Souza @mhenrique028]

New from us in Current Obesity Reports.

In this synthesis of MRI studies, intrapancreatic fat deposition was substantially higher in type 2 diabetes, beyond differences in BMI, age, and liver fat.
https://t.co/JRQpIuMuFM

#diabetes #GITwitter #MedTwitter

[Matheus Souza @mhenrique028]

Great team effort with Stella, Saeed, Mantovani, @PojsakornDan, and Max!

[Matheus Souza @mhenrique028]

New from us in Current Obesity Reports.

In this synthesis of MRI studies, intrapancreatic fat deposition was substantially higher in type 2 diabetes, beyond differences in BMI, age, and liver fat.
https://t.co/JRQpIuMuFM

#diabetes #GITwitter #MedTwitter

[sᴀᴍᴜᴇʟ ᴠᴇɴᴀ̂ɴᴄɪo ™ @samuelvenancio]

OBRIGADO, PAPAI DO CÉU!

[Matheus Souza @mhenrique028]

New publication in Liver International!
In our synthesis, we found that SLD is common in autoimmune liver diseases and is linked to greater metabolic burden.
https://t.co/PXYacDiKeP

Great teamwork with @IvannaDiazA, Saeed and @PojsakornDan

#livertwitter #GITwitter #MedTwitter

[Akash Roy @RoyAHep]

BMI Impacts VCTE measures
🚨 How does discordance play out in 🇮🇳 cohorts against MRE
As BMI increased, discordance skyrocketed 📈
💡7.7% (BMI &lt;25) ➡️ 64.7% (BMI ≥35)
For obesity-aware fibrosis assessment in MASLD
👇🏽
https://t.co/WeMiIy1sVJ

[Matheus Souza @mhenrique028]

@ZattarRafael 3 corações gourmet parece um chá

[Matheus Souza @mhenrique028]

One of my dreams was to be part of top meetings in GI/Hep, like #DDW2026

Thanks to wonderful colleagues, our work will be there. One day, I hope to attend in person. For now, I’m grateful and cheering from Rio.

Excited to see Stella and Saeed shine tomorrow!

[Matheus Souza @mhenrique028]

Looking forward to the poster presentations by Stella and Saeed at #DDW2026!

Our posters will be presented on May 5th (Exocrine Pancreatic Diseases and Diabetes session).
#GITwitter #MedTwitter