非酒精性脂肪肝、非酒精性脂肪胰與糖尿病的交互作用及處置

The Interplay among NAFLD, NAFPD and Diabetes and their Management

非酒精性脂肪胰臟疾病（NAFPD）為異位脂肪堆積的一種表現，常與肥胖、代謝症候群、第2型糖尿病及非酒精性脂肪肝（NAFLD）共存。脂肪酸過度積聚會引發胰臟慢性發炎、胰島素阻抗及β細胞功能損害，進一步促進糖尿病與胰臟癌發展。NAFPD全球盛行率逐年上升，與年齡、腹部肥胖、NAFLD、糖尿病等代謝異常密切相關。影像學技術已可協助早期診斷。研究指出，GLP-1 RA與SGLT2抑制劑可改善胰臟脂肪沉積並改善代謝功能，顯示潛在治療效果。生活型態介入如控制體重、運動與飲食亦具預防意義。NAFPD不僅是代謝疾病的指標，更可能為病程惡化的關鍵。未來研究應聚焦於非侵入性診斷工具、建立早期風險預測模型與個別化治療策略，以降低NAFPD所帶來的健康風險，並改善臨床照護成果。

Non-alcoholic fatty pancreas disease (NAFPD) represents a form of ectopic fat accumulation and is frequently comorbid with obesity, metabolic syndrome, type 2 diabetes mellitus (T2DM), and non-alcoholic fatty liver disease (NAFLD). Excessive deposition of fatty acids in the pancreas can trigger chronic inflammation, insulin resistance, andβ-cell dysfunction, thereby contributing to the progression of diabetes and potentially pancreatic cancer. The prevalence of NAFPD is increasing globally and is closely associated with age, abdominal obesity, NAFLD, and other metabolic derangements. Advances in imaging modalities have facilitated earlier detection of pancreatic steatosis. Emerging evidence suggests that GLP-1 receptor agonists and SGLT2 inhibitors may ameliorate pancreatic fat accumulation and improve metabolic function, indicating therapeutic potential. Lifestyle interventions such as weight control, physical activity, and dietary modifications also play a preventive role. NAFPD is not only a marker of metabolic disease but may also act as a key driver of disease progression. Future research should focus on the development of non-invasive diagnostic tools, early risk prediction models, and personalized treatment strategies to mitigate the health burden of NAFPD and improve clinical outcomes.