Associations of Dietary Fatty Acids with Pancreatic Steatosis: A Case-Control Study among Patients with Gallstones

Introduction: Pancreatic steatosis (PS) is increasingly recognized as a metabolic condition with potential links to diabetes and pancreatic cancer. Dietary fat composition may play a critical role in its development. This study investigated the association between dietary fat intake and the risk of PS. Methods: In this case-control study, 278 patients with gallstones were enrolled, of whom 89 were diagnosed with PS using endoscopic ultrasonography. Dietary fat intake was assessed using a validated food frequency questionnaire. Logistic regression was applied to estimate odds ratios (ORs) across tertiles of fat intake, adjusting for age, sex, BMI, and energy intake. Results: In crude analyses, total fat intake was not significantly associated with PS. After adjustment, total fat intake showed a significant positive association. Cholesterol intake was linked to a four-fold higher risk (OR: 4.27, 95% CI 2.1-8.5, P-trend = 0.001) and saturated fatty acids (SFAs) to a three-fold higher risk (OR: 3, 95% CI 1.5-6, P-trend = 0.002). Moderate intake of monounsaturated fatty acids (MUFAs) appeared protective. No significant association was observed for total polyunsaturated fatty acids (PUFAs), but n-3 PUFAs showed an inverse association, whereas n-6 PUFAs showed a direct association with PS risk. Discussion: These findings suggest that dietary fat composition, rather than total fat alone, is associated with PS. The observed associations highlight the importance of distinguishing between fat subtypes in pancreatic health. Conclusion: Excessive intake of SFAs, n-6 PUFAs, cholesterol, and total fat increases PS risk, whereas MUFAs and n-3 PUFAs may be protective. Prospective studies are warranted to confirm these associations and clarify causal pathways.