Nonalcoholic Fatty Liver Disease in Children with Hypopituitarism

Abstract

Objectives and Study: It has been reported that children with hypopituitarism have features of metabolic syndrome. The aim of this study was to investigate the clinical features and liver histology of pediatric nonalcoholic fatty liver disease (NAFLD) associated with hypopituitarism. Method(s): We reviewed the clinical data and liver histology of eleven children diagnosed as having hypopituitarism and NAFLD. Diagnosis of NAFLD was based on evidence of a fatty liver from abdominal computerized tomography (CT). Result(s): The mean age at the time of diagnosis of hypopituitarism was 10.4 years and the mean age at the time of diagnosis of NAFLD was 13.1 years. Craniopharyngioma was the most common cause of pituitary dysfunction. At the time of diagnosis of NAFLD, nine patients (82%) had a body mass index greater than the 85th percentile, four patients (36%) had elevated fasting blood glucose levels and seven (64%) had hypertriglyceridemia. Of the six patients biopsied, one was cirrhotic, two had nonalcoholic steatohepatitis (NASH) with bridging fibrosis, two had NASH with mild portal fibrosis and one had simple steatosis. Conclusion(s): Children with hypopituitarism are at risk of short stature, obesity, hyperlipidemia and NAFLD. Early diagnosis of NAFLD is important in children with hypopituitarism because NASH is common.