Background & Aims: Although, there has been reports demonstrating association between adult-onset hypopituitarism and development of nonalcoholic fatty liver disease (NAFLD), studies are lacking regarding the development of NAFLD in children and young adult with childhood-onset hypopituitarism. We aimed to identify association between NAFLD and hypopituitarism in these patients.
Methods: 76 Korean children and young adults with childhood-onset hypopituitarism and age-, BMI-matched 58 controls were recruited. Using FibroScan and/or magnetic resonance for fat quantification, we examined the stage of liver steatosis and liver fibrosis.
Results: Compared with controls, the prevalence of NALFD was significantly higher in patients with hypopituitarism. Six patients showed liver cirrhosis on FibroScan. Hypopituitary patients with NAFLD had were more obese and had longer duration without growth hormone (GH) replacement and had lower insulin-like growth factor I (IGF-I) and IGF-I/insulin-like growth factor binding protein 3 (IGFBP3) molar ratio compared to patients without NAFLD. Hypopituitary patients with liver fibrosis had longer duration without GH replacement compared to patient without liver fibrosis. After adjusting for BMI-SDS, odds ratios of duration without GH replacement, IGF-I SDS, and molar ratio of IGF-I/IGFBP3 for NAFLD were 1.764 (95% CI: 1.252, 2.485), 0.519 (95% CI: 0.315-0.856) and 0.001(95% CI: 0.000, 0.078), respectively. After BMI-SDS adjustment . Odds ratio of duration without GH replacement for liver fibrosis was 1.143 (95% CI: 1.003, 1.303)
Conclusions: The prevalence of NAFLD was significantly higher in patients with hypopituitarism. NAFLD including NASH and liver cirrhosis could be seen from childhood. Growth hormone replacement therapy demonstrated a possibility to prevent the development and progression of NAFLD in these patients
19 - 21 Sep 2019
European Society for Paediatric Endocrinology