Clinical characteristics of non-alcoholic fatty liver disease in Chinese adult hypopituitary patients

Yuan, Xianxian; Zhu, Huijuan; Pan, Hui; Chen, Shi; Liu, Zeyu; Li, Yue; Wang, Linjie; Lü, Lin; Yang, Hongbo; Gong, Fengying

doi:10.3748/wjg.v25.i14.1741

Cited by 16 publications

(20 citation statements)

References 29 publications

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“…Considering the underlying pituitary abnormalities, patients with PSIS often present with multiple pituitary hormone deficiencies. GH, TSH, ACTH, LH/FSH deficiency, and diabetes insipidus were present in 99.0%, 93.6%, 75.7%, 99.0%, and 9.7%, respectively, which agrees with the observations made by other studies 15,16 . The incidence of NAFLD based on abdominal ultrasonography was 50.5%, similar to that reported by Yuan et al 15 (54.0%) and slightly lower than that in other reports (70.7%–77%) 3,16,17 .…”

Section: Discussionsupporting

confidence: 90%

“…GH, TSH, ACTH, LH/FSH deficiency, and diabetes insipidus were present in 99.0%, 93.6%, 75.7%, 99.0%, and 9.7%, respectively, which agrees with the observations made by other studies 15,16 . The incidence of NAFLD based on abdominal ultrasonography was 50.5%, similar to that reported by Yuan et al 15 (54.0%) and slightly lower than that in other reports (70.7%–77%) 3,16,17 . The difference may be explained by the following reasons.…”

Section: Discussionsupporting

confidence: 90%

“…Primarily, the underlying etiology of hypopituitarism was miscellaneous and dominated by hypothalamic-pituitary tumors in other reports. 3,[15][16][17] To the best of our knowledge, this is the first study to investigate the predicted factors associated with NAFLD by focusing on patients with PSIS. Secondly, the method of diagnosing NAFLD varied between studies, including abdominal ultrasonography, vibrationcontrolled transient elastography, proton density fat fraction, and liver biopsy.…”

Section: Association Between Nafld and Igf-1 In Patients With Psismentioning

confidence: 99%

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Relationship between growth hormone deficiency and nonalcoholic fatty liver disease in patients with pituitary stalk interruption syndrome

Huang

Wang

et al. 2022

Clinical Endocrinology

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Background Pituitary stalk interruption syndrome (PSIS), characterized by thinning or disappearance of the pituitary stalk, hypoplasia of the anterior pituitary, and an ectopic posterior pituitary, can lead to congenital combined pituitary hormone deficiency. There is a high prevalence of various metabolic disorders, including nonalcoholic fatty liver disease (NAFLD), in this population. Objective To investigate the characteristics of NAFLD in Chinese adult patients with PSIS and its association with growth hormone deficiency. Design Retrospective cross‐sectional study in a tertiary referral center of China. Patients Adult patients with PSIS diagnosed, followed up between September 2019 and August 2021, were consecutively enrolled. Measurements Abdominal ultrasonography images were evaluated and noninvasive fibrosis scores were determined to assess the severity of NAFLD. Anthropometric, clinical, and biochemical parameters were compared between patients with and without NAFLD. Logistic regression was performed to assess the independent effects of insulin‐like growth factor‐1 (IGF‐1) on NAFLD. Results A total of 93 patients (77 men, 16 women, mean age: 29.6 ± 7.1 years) were included. The prevalence of NAFLD and advanced fibrosis/cirrhosis was 50.5% and 4.3%, respectively. Insufficient hormone therapy and prominent metabolic disorders, including central obesity, dyslipidemia, insulin resistance, and metabolic syndrome, were more common in the NAFLD (+) group. After adjusting for multiple variables, IGF‐1 <−2 standard deviation score (SDS) was found to be associated with an increased prevalence of NAFLD (odds ratio [OR]: 4.92, 95% confidence interval [CI]: 1.21–24.55, p = .035). Per 1 SDS increase in IGF‐1 was associated with a 27% lower risk of NAFLD (OR: 0.73, 95% CI: 0.52–0.97, p = .042). Conclusion NAFLD is a frequent comorbidity among Chinese adult patients with PSIS and is strongly associated with lower IGF‐1 levels. Timely and appropriate hormone replacement, particularly growth hormone may contribute to decreasing the risk of NAFLD in these patients.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Section: Association Between Nafld and Igf-1 In Patients With Psismentioning

confidence: 99%

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Relationship between growth hormone deficiency and nonalcoholic fatty liver disease in patients with pituitary stalk interruption syndrome

Huang

Wang

et al. 2022

Clinical Endocrinology

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“…The prevalence of obesity and hyperlipidemia in patients with GH deficiency is high[ 7 ]. In addition, studies have found that the prevalence of nonalcoholic fatty liver disease (NAFLD) is high in patients with hypopituitarism, and the severity of GH deficiency is positively correlated with the severity of hepatic steatosis in NAFLD[ 8 , 9 ]. Interestingly, NAFLD develops quickly in patients with hypothalamic dysfunction or hypopituitarism[ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Pituitary stalk interruption syndrome and liver changes: From clinical features to mechanisms

Wu¹,

Li²,

Chang³

2020

WJG

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Pituitary stalk interruption syndrome (PSIS) is a rare congenital abnormality characterized by thinning or disappearance of the pituitary stalk, hypoplasia of the anterior pituitary and an ectopic posterior pituitary. Although the etiology of PSIS is still unclear, gene changes and perinatal adverse events such as breech delivery may play important roles in the pathogenesis of PSIS. PSIS can cause multiple hormone deficiencies, such as growth hormone, which then cause a series of changes in the human body. On the one hand, hormone changes affect growth and development, and on the other hand, they could affect human metabolism and subsequently the liver resulting in nonalcoholic fatty liver disease (NAFLD). Under the synergistic effect of multiple mechanisms, the progression of NAFLD caused by PSIS is faster than that due to other causes. Therefore, in addition to early identification of PSIS, timely hormone replacement therapy and monitoring of relevant hormone levels, clinicians should routinely assess the liver function while managing PSIS.

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“…Hypopituitarism, which induces a condition similar to metabolic syndrome, is associated with NAFLD. We found that the NAFLD prevalence in patients with hypopituitarism (52.24%) was notably higher than that in the generation population (25%, reported in 2016) [15]; however, it was similar to that reported in Chinese adult patients with hypopituitarism (54%) [16]. More attention should be paid to NAFLD caused by hypopituitarism since such cases can rapidly progress to cirrhosis even at a young age [17].…”

Section: Discussionmentioning

confidence: 67%

Associations among FT4 level, FT3/FT4 ratio, and non-alcoholic fatty liver disease in Chinese patients with hypopituitarism

et al. 2022

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Non-alcoholic fatty liver disease (NAFLD) is the most common hepatic metabolic disorder. Thyroid function is associated with NAFLD in different populations; however, little attention has been paid in patients with hypopituitarism. To analyze the association between thyroid function and NAFLD, we included 134 patients with hypopituitarism admitted to the Tianjin Medical University General Hospital between June 2013 and May 2019. Participants were divided into the NAFLD(-) and NAFLD(+) groups based on abdominal ultrasonography findings. We evaluated 68 male and 66 female patients with hypopituitarism. The prevalence of NAFLD was 52.24%. The NAFLD(+) group had a significantly higher free triiodothyronine/free thyroxine (FT 3 /FT 4 ) ratio than the NAFLD(-) group (p = 0.003). The NAFLD(+) group showed significantly lower levels of FT 4 and the growth hormone (GH) than the NAFLD(-) group (p = 0.003 and 0.016, respectively). We observed an association of the FT 4 level and FT 3 /FT 4 ratio with NAFLD in the univariate model, which was nonsignificant after adjustment for metabolic parameters (BMI, HDL-C, triglycerides, serum uric acid, blood pressure, fasting glucose). To better understand the role of each metabolic parameters, we performed additional models for each of those predictors individually after adjustment for age and gender, the association between FT 4 level and FT 3 /FT 4 ratio lost significance after adjustment for HDL-C and TG, but not for other predictors. Our findings suggest that thyroid dysfunction may be crucially involved in NAFLD by regulating whole-body metabolism, especially lipid utilization. Therefore, sufficient thyroid hormone replacement therapy for patients with hypopituitarism is recommended from the early stage.

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Clinical characteristics of non-alcoholic fatty liver disease in Chinese adult hypopituitary patients

Cited by 16 publications

References 29 publications

Relationship between growth hormone deficiency and nonalcoholic fatty liver disease in patients with pituitary stalk interruption syndrome

Relationship between growth hormone deficiency and nonalcoholic fatty liver disease in patients with pituitary stalk interruption syndrome

Pituitary stalk interruption syndrome and liver changes: From clinical features to mechanisms

Associations among FT<sub>4</sub> level, FT<sub>3</sub>/FT<sub>4</sub> ratio, and non-alcoholic fatty liver disease in Chinese patients with hypopituitarism

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