뇌하수체저하증 소아에서 발생한 비알코올성 지방간질환
Nonalcoholic Fatty Liver Disease in Children with Hypopituitarism
윤정민, 고재성, 서정기, 신충호, 양세원, 문진수, 양혜란, 장주영,
소속 상세정보
윤정민 ( Yoon Jung-Min )
서울대학교 의과대학 소아과학교실
고재성 ( Ko Jae-Sung )
서울대학교 의과대학 소아과학교실
서정기 ( Seo Jeong-Kee )
서울대학교 의과대학 소아과학교실
신충호 ( Shin Choong-Ho )
서울대학교 의과대학 소아과학교실
양세원 ( Yang Sei-Won )
서울대학교 의과대학 소아과학교실
문진수 ( Moon Jin-Soo )
인제대학교 의과대학 일산백병원 소아청소년과
양혜란 ( Yang Hye-Ran )
서울대학교 의과대학 소아과학교실
장주영 ( Jang Ju-Young )
서울대학교 의과대학 소아과학교실
KMID : 0816120100130010051
Abstract
Purpose: It has been reported that children with hypopituitarism have features of metabolic syndrome, including obesity, impaired glucose tolerance, and dyslipidemia. The aim of this study was to investigate the clinical features and liver histology of pediatric non-alcoholic fatty liver disease (NAFLD) associated with hypopituitarism.
Methods: We reviewed the clinical data of 11 children diagnosed with NAFLD among patients with hypopituitarism.
Results: The mean age at the time of diagnosis of hypopituitarism was 10.4±3.2 years, and the mean age at the time of diagnosis of NAFLD was 13.1±2.7 years. A craniopharyngioma was the most common cause of pituitary dysfunction. At the time of diagnosis of NAFLD, 9 patients (82%) had a body mass index greater than the 85th percentile, 5 patients (45%) had elevated fasting blood glucose levels, and 9 patients (82%) had hypertriglyceridemia. The mean height SD score was significantly lower at the time of diagnosis of NAFLD than at the time of diagnosis of hypopituitarism. Of the six patients who were biopsied, one had cirrhosis, two had non-alcoholic steatohepatitis (NASH) with bridging fibrosis, two had NASH with mild portal fibrosis, and one had simple steatosis.
Conclusion: Children with hypopituitarism are at risk of short stature, obesity, dyslipidemia, and NAFLD. The early diagnosis of NAFLD is important in children with hypopituitarism because advanced fibrosis is common.
키워드
Child; Fatty liver; Hypopituitarism; Obesity
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