Physicians from Rochester, Minnesota, examined the associations between hypopituitarism, hypothalamic dysfunction, and nonalcoholic fatty liver disease (NAFLD).
They assessed a case series of 21 patients with diagnoses of hypopituitarism, hypothalamic obesity, or craniopharyngioma and NAFLD.
The team reviewed clinical, laboratory, and liver biopsy features.
|NAFLD was diagnosed a median of 3 years after hypothalamic/pituitary dysfunction.|
The physicians found that NAFLD was diagnosed a median of 3 years after the diagnosis of hypothalamic/pituitary dysfunction.
They determined that the mean gain in body mass index (BMI) between diagnoses of hypothalamic/pituitary disease and NAFLD was 11.3 kg/m2. This was an average yearly gain of 2.2 kg/m2.
They found that the majority of patients developed elevated glucose levels and dyslipidemia by time of diagnosis of NAFLD.
There were 10 patients biopsied. Of these 6 were cirrhotic, 2 had nonalcoholic steatohepatitis with fibrosis, and 2 had simple steatosis.
The team had long-term follow-up data for 18 patients. Overall, 2 patients required liver transplantation, and 6 died, 2 from liver related causes.
Dr Leon Adams and colleagues concluded, "Patients with hypothalamic and/or pituitary disease are at risk of excessive weight gain, impaired glucose tolerance, and dyslipidemia with subsequent development of NAFLD".
"This group has a high prevalence of cirrhosis placing them at risk for liver-related death".
"The novel evidence that hypothalamic/pituitary dysfunction may be accompanied by progressive NAFLD has important implications for the work-up and management of patients with hypothalamic/pituitary disease".