Journal of Clinical Pediatrics >
A study examining the association between hypopituitarism and metabolic-associated fatty liver disease following surgery for tumors in the sellar region among children
Received date: 2024-09-05
Accepted date: 2025-03-13
Online published: 2025-06-01
Objective To investigate the clinical relationship between hypopituitarism and metabolic-associated fatty liver disease (MAFLD) in children with sellar region tumor after surgery. Methods From January 2017 to December 2023, patients with hypopituitarism resulting from sellar tumors were consistently monitored for over a year. All patients were categorized into either the MAFLD (+) group or the MAFLD (-) group based on liver ultrasonography. A comparison was then made between the clinical and biochemical parameters of the two groups. Results A total of 33 patients were included, with 16 patients (48.5%) in the MAFLD (+) group and 17 patients (51.5%) in the MAFLD (-) group. There were no significant differences in age or gender between the two groups. All patients had GHD (100%) and CH (100%). AI was present in 30 patients (91%), with equal distribution between the MAFLD (+) and (-) groups (50% each). CDI was diagnosed in 22 patients (66.7%), with more patients in the MAFLD (-) group (63.6%) compared to the MAFLD (+) group (36.4%). Hypernatremia hypodipsia occurred in 7 patients (21.2%), all belonging to the MAFLD (+) group. All CH patients were treated with oral levothyroxine sodium tablets, while 30 AI patients received oral hydrocortisone tablets. The height SDS and BMI were significantly higher in the MAFLD (+) group compared to the MAFLD (-) group (P<0.001). Fasting blood glucose, insulin, HOMA-IR, ALT, γ-GT, UA, PRL, and TG levels were significantly elevated in the MAFLD (+) group compared to the MAFLD (-) group, while HDL-C levels were significantly lower (P<0.05). No significant differences were observed in IGF-1 SDS, FT3, FT4, T3, T4, TSH, TBil, AST, Alb, TC, and LDL-C between the two groups. After treatment with recombinant human growth hormone (rhGH), there was a statistically significant decrease in TG and LDL-C levels among the patients. Conclusion After surgery for sellar region tumors, patients with hypopituitarism often experience a high incidence of MAFLD and hypothalamic dysfunction. This dysfunction can manifest as hypothalamic obesity, hypernatremia, and elevated prolactin levels, all of which increase the risk of developing MAFLD. Furthermore, treatment with rhGH may help improve metabolic markers among these patients.
DU Tingting , YAO Hui , CHEN Xiaohong , YANG Luhong , FENG Lifang , CHEN Xiaoqian , HU Man , LI Yakun . A study examining the association between hypopituitarism and metabolic-associated fatty liver disease following surgery for tumors in the sellar region among children[J]. Journal of Clinical Pediatrics, 2025 , 43(6) : 438 -444 . DOI: 10.12372/jcp.2025.24e0929
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