Nonalcoholic fatty liver disease in long-term survivors of childhood-onset craniopharyngioma.
10.6065/apem.2017.22.3.189
- Author:
So Yoon JUNG
1
;
Yun Jeong LEE
;
Hye Jin LEE
;
Young Ah LEE
;
Jin Soo MOON
;
Jae Sung KO
;
Sei Won YANG
;
Choong Ho SHIN
Author Information
1. Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea. chshinpd@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Child craniopharyngioma;
Nonalcoholic fatty liver disease;
Growth hormone deficiency;
Hypothalamus;
Obesity
- MeSH:
Alanine Transaminase;
Aspartate Aminotransferases;
Body Mass Index;
Craniopharyngioma*;
Diagnosis;
Growth Hormone;
Humans;
Hypothalamus;
Liver;
Non-alcoholic Fatty Liver Disease*;
Obesity;
Overweight;
Prevalence;
Retrospective Studies;
Survivors*
- From:Annals of Pediatric Endocrinology & Metabolism
2017;22(3):189-196
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Hypothalamic obesity in childhood-onset (CO-) craniopharyngioma patients may predispose to nonalcoholic fatty liver disease (NAFLD). This study reviewed the characteristics of NAFLD associated with CO-craniopharyngioma. METHODS: This study retrospectively reviewed 75 patients who underwent surgery for craniopharyngioma while younger than 15 years of age between 2000 and 2016. RESULTS: Elevated aspartate aminotransferase (AST) or alanine aminotransferase (ALT) above 40 IU/L was observed in 51 of the 75 (68%) CO-craniopharyngioma patients. Imaging studies were performed in 32 patients with elevated liver enzymes. The estimated prevalence of NAFLD in CO-craniopharyngioma was 47%. NAFLD was detected in 22 patients (male 59%, 4.3±4.0 years after first surgery). The mean age at the time of the initial operation was 9.1±2.9 years. Six patients (27.3%) were diagnosed within 1 year. Among the 19 patients with initial height and weight data, the body mass index (BMI) z-score (BMI_Z) at the time of diagnosis with NAFLD was 1.37±1.01 (range, -0.75 to 3.18), with 4 patients (18.2%) being overweight and 9 (40.9%) being obese. BMI_Z increased above BMI_Z at the time of the operation in 13 patients (68.4%). The increment in BMI_Z was 1.13 (range, 0.10–2.84). Seventeen patients did not receive growth hormone. An insulin-like growth factor-I level < 3rd percentile was observed in 19 patients. CONCLUSION: NAFLD is common in survivors of CO-craniopharyngioma and may develop earlier. If the ALT or AST is above 40 IU/L, a diagnostic work-up should be started.
