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High Prevalence of Nonalcoholic Fatty Liver Disease Among Adolescents and Young Adults With Hypopituitarism due to Growth Hormone Deficiency

 Seok Jin Kang  ;  Ahreum Kwon  ;  Mo Kyung Jung  ;  Hyun Wook Chae  ;  Seung Kim  ;  Hong Koh  ;  Hyun Joo Shin  ;  Ho-Seong Kim 
 ENDOCRINE PRACTICE, Vol.27(11) : 1149-1155, 2021-11 
Journal Title
Issue Date
Adolescent ; Child ; Cross-Sectional Studies ; Growth Hormone ; Humans ; Hypopituitarism* / epidemiology ; Hypopituitarism* / etiology ; Insulin-Like Growth Factor I ; Non-alcoholic Fatty Liver Disease* / complications ; Non-alcoholic Fatty Liver Disease* / epidemiology ; Prevalence ; Young Adult
childhood-onset ; growth hormone deficiency ; hypopituitarism ; liver fibrosis ; nonalcoholic fatty liver disease
Objective: To investigate the prevalence of nonalcoholic fatty liver disease (NAFLD) in adolescents and young adults with hypopituitarism and to examine the associations of growth hormone (GH) deficiency with the occurrence of NAFLD.

Methods: A cross-sectional study for the determination of NAFLD prevalence included 76 patients with childhood-onset hypopituitarism and 74 controls matched by age and body mass index (BMI). We investigated the prevalence of NAFLD in adolescent and young adult patients with hypopituitarism as well as the age- and BMI-matched controls. Among patients with hypopituitarism, anthropometric, clinical, and biochemical assessments using transient elastography and magnetic resonance imaging were performed. Logistic regression was used to identify the factors associated with NAFLD.

Results: The adolescents and young adults with hypopituitarism exhibited higher prevalence of NAFLD than the age- and BMI-matched controls. Among patients with hypopituitarism, obesity and obesity-related metabolic derangements were significantly associated with liver steatosis and fibrosis, whereas lower insulin-like growth factor (IGF)-I standard deviation score (SDS) and IGF-I/IGF-binding protein 3 molar ratios were associated with steatosis. In regression analyses adjusted for BMI SDS, steatosis was found to be associated with a lower IGF-I SDS and IGF-I/IGF-binding protein 3 molar ratios, whereas liver fibrosis was found to be associated with a lower IGF-I SDS.

Conclusion: Our results suggest that GH deficiency contributes to the occurrence of NAFLD, along with obesity and obesity-related metabolic changes. Because NAFLD occurs early in patients with hypopituitarism, the surveillance, weight control, and timely replacement of deficit hormones, including GH, are essential.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Koh, Hong(고홍) ORCID logo https://orcid.org/0000-0002-3660-7483
Kwon, Ah Reum(권아름) ORCID logo https://orcid.org/0000-0002-9692-2135
Kim, Seung(김승) ORCID logo https://orcid.org/0000-0003-4373-9828
Kim, Ho Seong(김호성) ORCID logo https://orcid.org/0000-0003-1135-099X
Shin, Hyun Joo(신현주) ORCID logo https://orcid.org/0000-0002-7462-2609
Jung, Mo Kyung(정모경)
Chae, Hyun Wook(채현욱) ORCID logo https://orcid.org/0000-0001-5016-8539
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