Prevalence of Non-Alcoholic Fatty Liver Disease in Patients with Childhood Onset Panhypopituitarism

Presentation Number: SAT 515
Date of Presentation: April 1st, 2017

Seok Jin Kang*1, Mo Kyung Jung1, Ah Reum Kwon1, Duk Hee Kim2, Ho-Seong Kim3, Hong Koh1, Seung Kim4 and Hyun-wook Chae1
1Yonsei University College of Medicine, Seoul, Korea, Republic of (South), 2Sowha Children's Hospital, Seoul, Korea, Republic of (South), 3College of Medicine Yonsei University, Seoul, Korea, Republic of (South), 4Yonsei University College of Medicine, Seoul

Abstract

Purpose

Recently, case reports and several studies suggest that panhypopituitarism is associated with increased prevalence of nonalcoholic fatty liver disease(NAFLD). NAFLD represents a spectrum of disease from simple steatosis to nonalcoholic steatohepatitis(NASH) and it may progress to liver cirrhosis We investigated the prevalence of NAFLD in adolescents and young adults with childhood-onset panhypopituitarism. We also analysed growth hormone replacement effect on the development of NAFLD

Patients and Methods :

A total of 36 patients[M/F 23/13, age 18.6± 5.7 years, range (10-29)] were included. Thirty five had growth hormone deficiency. To exam the prevalence of NAFLD, patients underwent transient elastography and hepatic fat quantification magnetic resonance imaging. We compared these patients with healthy age- and BMI-matched controls. Clinical and laboratory parameters were reviewed.

Results

The prevalence of NAFLD in patients with panhypopituitarism was significantly higher than in controls(69.4% vs 27.3%, P<0.01) on transient elastography. Patient’s mean BMI SDS was 0.75 ± 1.37. NAFLD was diagnosed 9.9 ± 6.6 years (1-23 years) after the diagnosis of panhypopituitarism. Mean gain of BMI SDS was 0.53 ± 1.38 during that period. Eleven patients (35%) showed liver fibrosis. One of with severe fibrosis underwent liver biopsy and the result was consistent with liver cirrhosis. We also performed MRI on 35 of 36 patients. The prevalence of NAFLD was higher than in controls.(62.9% vs 27.3%, p<0.01) The prevalence of those was lower in patients who had received growth hormone more than 1 year at the time of MRI evaluation.(27 % vs 72.7%, p<0.05). Triglyceride, ALT, and BMI were significantly elevated in hypopituitary patients with fatty liver compared to patients without fatty liver

Conclusions

Patients with panhypopituitarism are at a risk of development of NAFLD. It can progress to NASH and cirrhosis like a our patient. Growth hormone replacement in GHD patients may have preventive effect to the development of NAFLD

 

Nothing to Disclose: SJK, MKJ, ARK, DHK, HSK, HK, SK, HWC