91 Quick summary: A systematic medical review has revealed that ectopic fat accumulation in the liver and pancreas affects up to 40% and 21% of people respectively, with metabolic dysfunction acting as the critical pathological link that drives chronic inflammation and elevates cancer risks in both organs. Clinical researchers note a bidirectional relationship between these fat depositions and type 2 diabetes mellitus, highlighting how modern sedentary habits, high calorie diets, and poor sleep hygiene accelerate organ tissue damage. These findings hold substantial significance for public health policy and clinical healthcare practice, demonstrating that while artificial intelligence tools and targeted therapies like glucagon like peptide 1 receptor agonists show diagnostic promise, a unified liver and pancreas co management strategy focused on early lifestyle intervention is essential to prevent severe systemic metabolic failure. Modern lifestyles marked by sedentary work and high-calorie diets have driven global obesity rates higher. A key feature of obesity is the accumulation of fat in organs not normally designed to store fat, including the liver, pancreas, and heart. These deposits, known as ectopic fat, can disrupt normal organ function and contribute to serious disease. A research team led by Dr Weihong Wang from the Department of Infectious Diseases, Dr Jing Zhong from the Center of Precision Medicine, and Professor Qiang Yan from the Division of Hepatobiliary and Pancreatic Surgery—all based at the Fifth School of Clinical Medicine of Zhejiang Chinese Medical University—have reviewed recent advances in understanding ectopic fat-related disorders. Their findings were published in the journal Portal Hypertension & Cirrhosis on 12th May, 2026. Dr Wang explained the scope of the work, saying: “We conducted a systematic review comparing definitions, pathology, diagnostic methods, and risk factors, as well as organ-specific effects. We also examined artificial intelligence (AI)-driven advancements, the current status of drug research, and the potential association between MASLD and IPFD. We further clarified the similarities and differences between these conditions.” The review focuses on two major conditions affecting the liver and pancreas: metabolic dysfunction-associated steatotic liver disease (MASLD) and intrapancreatic fat deposition (IPFD). MASLD affects the liver, while intrapancreatic fat deposition (IPFD) affects the pancreas. MASLD prevalence in the Asia-Pacific region is estimated to range from 28%–40% based on blood tests, imaging, and biopsy-confirmed diagnostic criteria. IPFD is more difficult to measure due to the lack of universally accepted diagnostic standards, but current estimates place its prevalence between 17%–21%. Both conditions are associated with chronic metabolic and organ-specific diseases. MASLD is linked to chronic liver inflammation and increases the risk of liver cancer and bile duct scarring. It is also associated with coexisting chronic hepatitis B infection and autoimmune hepatitis. IPFD is associated with pancreatitis, pancreatic insufficiency, and increased pancreatic cancer risk. The review highlights that MASLD and IPFD often occur alongside other conditions, particularly type 2 diabetes mellitus and low levels of high-density lipoprotein (HDL) cholesterol in the blood. Evidence also suggests a bidirectional relationship between type 2 diabetes and both MASLD and IPFD. Lifestyle factors play a major role in disease development. High-calorie diets, physical inactivity, smoking, and insufficient sleep are associated with increased ectopic fat accumulation. The authors note that lifestyle modification may reduce fat deposition in both the liver and pancreas and improve organ function. Emerging therapies also show promise. Glucagon-like peptide-1 (GLP-1) receptor agonists such as semaglutide may benefit MASLD, while statins and antihypertensive medications may improve outcomes in IPFD. Dr Zhong noted the link between the two conditions, saying: “There may be a close association between MASLD and IPFD, with metabolic dysfunction acting as the key pathological link.” Artificial intelligence is increasingly being used to improve diagnosis, particularly for IPFD, which currently lacks clear diagnostic criteria. AI tools are also being combined with organ-on-a-chip systems to model liver and pancreatic function, helping researchers evaluate potential treatments more efficiently. The review also highlights an imbalance in research progress. MASLD has seen significant advances in both basic science and clinical research, while IPFD remains under-studied. The authors stress the need for a unified definition of IPFD and a deeper understanding of its underlying molecular mechanisms. Summarising the implications of the findings, Professor Yan said: “Our study suggests that an integrated liver–pancreas co-management strategy, with innovative organ-targeted treatment approaches, may open new avenues for precision prevention and therapy.” The review concludes that ectopic fat accumulation in the liver and pancreas is a growing public health concern. While AI-driven diagnostics and targeted therapies are advancing, lifestyle modification remains the most effective strategy for prevention. Continued research into the shared mechanisms of MASLD and IPFD may improve early intervention and long-term disease management.