Algorithm for Early Detection of Pancreatic Steatosis in Primary Healthcare

Abstract

Aim: to develop and evaluate an algorithm for the early detection of pancreatic steatosis in a primary healthcare setting, and to substantiate measures for primary and secondary prevention.

Materials and Methods: the study was conducted in three stages. In the first stage, a questionnaire survey was performed among 3,135 individuals aged 34–75 years attached to family polyclinics of the Mirzo-Ulugbek and Shaykhantakhur districts. In the second stage, 1,530 patients with moderate and high risk underwent comprehensive clinical, laboratory, and instrumental examination, including anthropometry, assessment of carbohydrate and lipid metabolism and liver enzymes, and ultrasound examination of the liver and pancreas. In the third stage, risk factors were analyzed and the algorithm was validated in 300 patients from the risk group. Statistical analysis included descriptive statistics, the Pearson χ² test, and logistic regression analysis.

Results: moderate and high risk of pancreatic steatosis was identified in 1,530 of 3,135 examined individuals (48.8%). According to ultrasound findings, pancreatic steatosis was diagnosed in 1,102 of 1,530 risk-group patients (72.0%). Independent predictors of the disease were hepatic steatosis (OR=4.57), abdominal obesity (OR=4.10), obesity (OR=3.46), hypertriglyceridemia (OR=2.94), age ≥50 years (OR=2.41), and impaired carbohydrate metabolism (OR=2.27), p<0.001. Upon validation, the algorithm demonstrated a sensitivity of 92.5%, specificity of 72.1%, and overall diagnostic accuracy of 86.7%. Application of the algorithm reduced conditional costs for comprehensive examination by 49.5%.

Conclusion: the developed algorithm for early detection of pancreatic steatosis is an accessible and practically applicable tool for primary healthcare. Its implementation allows timely identification of risk-group patients, optimizes referral pathways, improves the efficiency of preventive examinations, and enables rational use of healthcare system resources.

Keywords:

Pancreatic steatosis, fatty pancreatic infiltration, primary healthcare

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