Prevalence of fatty liver and diabetes mellitus in patients with fatty pancreas disorder (FPD): A meta-analysis and systematic review.

Fatty pancreas disorder (FPD) is associated with metabolic disturbances, but the burden of hepatic steatosis and glucose abnormalities remains unclear. This meta-analysis assessed the prevalence of fatty liver and diabetes mellitus (DM) in patients with FPD. We systematically searched PubMed, Scopus, and Web of Science up to May 2026. Random-effects models pooled prevalence and odds ratios (ORs), with subgroup analyses by imaging modality and geographic region. From 746 records, 19 studies comprising 6,834 FPD patients were included. FPD was diagnosed using ultrasound, CT, MRI, or EUS with standardised criteria. The pooled prevalence of fatty liver was 59.0 % (95 %CI 51.1-66.6) and DM was 20.6 % (95 %CI 15.0-26.8); MRI/MRS studies reported higher rates (76.5 % and 27.7 %, respectively). FPD was associated with significantly higher odds of fatty liver (OR = 7.87, 95 %CI 5.09-12.17) and DM (OR = 3.19, 95 %CI 2.11-4.82) compared with non-FPD. The strong association between FPD and fatty liver suggests shared metabolic drivers in ectopic fat deposition. FPD may serve as a marker of systemic metabolic dysfunction, supporting screening for hepatic steatosis and glucose abnormalities, with weight loss remaining a core strategy.