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Positive association between nonalcoholic fatty liver disease and growth hormone deficiency in patients with nonfunctioning pituitary adenoma

 Yoon-A Hwang  ;  Hye Won Lee  ;  Sang Hoon Ahn  ;  Eun Jig Lee  ;  Cheol Ryong Ku  ;  Seung Up Kim 
 FRONTIERS IN ENDOCRINOLOGY, Vol.13 : 1057769, 2023-01 
Journal Title
Issue Date
Adenoma* / complications ; Adenoma* / epidemiology ; Adenoma* / surgery ; Adult ; Female ; Human Growth Hormone* ; Humans ; Hypogonadism* / complications ; Hypogonadism* / epidemiology ; Hypopituitarism* / complications ; Hypopituitarism* / epidemiology ; Male ; Non-alcoholic Fatty Liver Disease* / complications ; Non-alcoholic Fatty Liver Disease* / epidemiology ; Pituitary Neoplasms* / complications ; Pituitary Neoplasms* / epidemiology ; Pituitary Neoplasms* / surgery
growth hormone ; growth hormone deficiency ; hepatic steatosis index ; nonalcoholic fatty liver disease ; nonfunctioning pituitary adenoma
Objective: Non-alcoholic fatty liver disease (NAFLD) is characterized by growth hormone deficiency (GHd). We investigated the association between NAFLD and GHd in patients with nonfunctioning pituitary adenomas (NFPA).

Design and methods: We recruited patients with NFPA who underwent transsphenoidal adenectomy between January 2005 and December 2018. Pituitary function was determined by the insulin tolerance test, thyroid hormone assay, and gonadal hormone levels. NAFLD was defined as a hepatic steatosis index greater than 36.

Results: Among 278 patients (mean age, 44.2 years; 58.6% [n=163] female), 103 (37.0%) had GHd, 139 (50.0%) had hypogonadism, and 75 (27.0%) had NAFLD. The prevalence of NAFLD was significantly higher in patients with GHd than in those without (36.9% vs. 21.1%, p=0.01). Even after adjusting for age, total cholesterol level, gonadal function, and prolactin level, patients with GHd had approximately two-fold higher prevalence of NALFD than those without GHd (adjusted odds ratio [OR]=1.85, 95% confidence interval [CI]=1.05-3.28, p=0.03). Among female patients, the prevalence of NALFD was significantly higher in those with GHd than in those without (adjusted OR=2.39, 95% CI=1.03-5.55, p=0.04); whereas, among male patients, the prevalence of NAFLD was statistically similar between those with and without GHd (p>0.05). In addition, gonadal function did not affect the prevalence of NAFLD in patients with NFPA (29.3% with eugonadism vs. 47.8% with hypogonadism, p=0.14).

Conclusion: Among patients with NFPA, the prevalence of NAFLD was two-fold higher in patients with GHd than that in those without GHd. Thus, screening for NAFLD might be required in NFPA patients with GHd.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ku, Cheol Ryong(구철룡) ORCID logo https://orcid.org/0000-0001-8693-9630
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Eun Jig(이은직) ORCID logo https://orcid.org/0000-0002-9876-8370
Lee, Hye Won(이혜원) ORCID logo https://orcid.org/0000-0002-3552-3560
Hwang, Yoon-A(황윤아)
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