@conference{
author = "Miljić, Dragana and Pekić, Sandra and Doknić, Mirjana and Stojanović, Marko and Nikolić-Đurović, Marina and Medić-Stojanoska, Milica and Milošević, Verica and Šošić-Jurjević, Branka and Ajdžanović, Vladimir and Jemuović, Zvezdana and Soldatović, Ivan and Popović, Vera and Petakov, Milan",
year = "2018",
abstract = "Previous studies reported increased prevalence of metabolic syndrome (MS) and
mortality rates from cardiovascular causes in hypopituitary patients. Fatty liver
disease was added recently to this unfavorable cardio-metabolic phenotype. We
studied the prevalence of MS and non-alcoholic fatty liver disease (NAFLD) in
unselected cohort of 282 hypopituitary patients (146 male), mean age 49.2G15.1
years, on standard replacement therapy (76.4% received l-thyroxin, 76%
hydrocortisone, 9.8% gonadal steroids, 4.6% desmopressin, 1.8% growth
hormone). Surrogat marker of MS, lipid acummulation product (LAP) was
calculated using gender specific formulas including waist circumference and
triglyceride level. Marker of NAFLD, fatty liver index (FLI) was calculated using
formula including body weight, height, waist circumference, triglyceride and
gamma glutamyl transferase levels. Hepatic steatosis was assessed by
ultrasonography and liver function tests. In this cross-sectional study, prevalence
of MS was 57.1% (using IDF) and 48.6% (with ATP III criteria). MS was more
common in females than males (IDF 63.2% vs 51.4%, PZ0.044; ATP III 54.4%
vs 43.2%, PZ0.059) and significantly associated with unreplaced hypogonadism
in female patients (PZ0.003). Statistically significant associations (P!0.001)
were found for MS and age, obesity, adult onset of hypopituitarism and NAFLD.
Prevalence of NAFLD in the cohort was 20.6%, based on ultrasonographic
features of hepatic steatosis, while in addition to this 7.1% had elevated liver
enzymes. For NAFLD, statistically significant associations were found with MS
(P!0.001), etiology of non-functioning pituitary macroadenoma (PZ0.006) and
growth hormone deficiency (PZ0.026). Hypopitutary patients with NAFLD had
more severe features of MS with significantly higher body mass index, waist
circumference, cholesterol and triglycerides, LAP and FLI, but lower HDL
compared to no-NAFLD patients (P!0.001). ROC analysis confirmed that LAP
and FLI were reliable markers of hepatic steatosis and functional hepatic
impairment resulting from NAFLD. MS is common in hypopituitarism, featuring
NAFLD in one third of hypopituitary patients with MS. Hypopituitary NAFLD
patients present with more severe MS and higher LAP and FLI indexes compared
to no-NAFLD patients. LAP and FLI are reliable markers of hepatic steatosis and
functional hepatic impairment, resulting from NAFLD. Complex interactions of
multiple pituitary hormone deficiencies and balance in their replacement are very
important for metabolic phenotype, as well as age, gender, obesity, adult onset
and etiology of hypopituitarism.",
publisher = "bioscientifica",
journal = "20th European Congress of Endocrinology; 2018 May 19-22; Barcelona, Spain",
title = "Clinical relevance of metabolic phenotype in hypopituitarism: what really matters?",
doi = "10.1530/endoabs.56.P821"
}
