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Akromegali hastalarında yağlı karaciğer

Yıl 2020, 2020 Özel Sayı, 33 - 38, 26.02.2020
https://doi.org/10.18663/tjcl.604304

Öz

Amaç: Akromegali hastalarında, diabetes mellitus, insülin
direnci ve hipertrigliseridemi gibi metabolik durumlara sıklıkla rastlanır.
Bizim amacımız, akromegali hastalarında, non alkolik yağlı karaciğer (NAFLD)
gelişmesinde etkili olan faktörleri saptamaktır.

Gereç
ve Yöntemler
:
60 (33 kadın, 27 erkek) akromegali hastası ve 52 sağlıklı kişiden (27 kadın ve
25 erkek) oluşan kontrol grubu retrospektif olarak incelendi. Hastaların ve
kontrol grubunun ortalama yaşı sırasıyla
44.11 ±13.83 ve
39.12±14.99’du. Beden kitle indeksi (BKİ), karaciğer ultrasonografisi ve
laboratuvar sonuçları dosyalarındaki kayıtlardan alındı. İstatistik analizlerde
IBM SPSS Versiyon 22.0
istatistiksel paket programı (IBM
Corporation, USA) kullanıldı.

Bulgular:
Akromegali hastalarında açlık kan şekeri, trigliserid, insülin benzeri büyüme
faktörü, büyüme hormonu (GH) ve CRP seviyeleri kontrol grubuna göre anlamlı
derecede yüksek, HDL düzeyleri anlamlı derecede düşük bulundu. Grupların BKİ ve
NAFLD oranları benzerdi. Akromegali hastalarında BKİ ve GH’un NAFLD gelişmesinde
en önemli iki faktör olduğu sonucuna ulaştık. NAFLD, hastanın BKİ, kilo ve yaşı
ile anlamlı derecede pozitif, GH düzeyi ile anlamlı derecede negatif korelasyon
gösterdi.







Sonuç:
Akromegali hastalarında, NAFLD gelişmesini etkileyen faktörler BKİ ve GH’dur.

Kaynakça

  • 1. Clemmons DR. Metabolic Actions of Insulin-Like Growth Factor-I in Normal Physiology and Diabetes. Endocrinol Metab Clin North Am 2012; 41: 425–43.
  • 2. Türkiye Endokrinoloji ve Metabolizma Derneği Hipofiz Çalışma Grubu. Hipofiz Hastalıkları Tanı, Tedavi ve İzlem Kılavuzu. ANKARA: 2018. p. 29–35.
  • 3. Rabinowitz D, Klassen GA, Zierler KL. Effect of Human Growth Hormone on Muscle and Adipose Tissue Metabolism. J Clin Invest 1965; 44: 51–61.
  • 4. Moøller N, Joørgensen JOL. Effects of growth hormone on glucose, lipid, and protein metabolism in human subjects. Endocr Rev 2009; 30: 152–77.
  • 5. Ciresi A, Guarnotta V, Campo D, Giordano C. Hepatic Steatosis Index in Acromegaly: Correlation with Insulin Resistance Regardless of the Disease Control. Int J Endocrinol. 2018; 5421961.
  • 6. Vijayakumar A, Novosyadlyy R, Wu YJ, Yakar S, LeRoith D. Biological effects of growth hormone on carbohydrate and lipid metabolism. Growth Horm IGF Res 2010; 20: 1–7.
  • 7. Colao A, Ferone D, Marzullo P, Lombardi G. Systemic Complications of Acromegaly: Epidemiology, Pathogenesis, and Management. Endocr Rev 2004; 25: 102–152.
  • 8. Alves-Bezerra M, Cohen D. Triglyceride Metabolism in the Liver. Compr Physiol 2017; 8: 1–8.
  • 9. Rinella ME. Nonalcoholic fatty liver disease a systematic review. JAMA - J Am Med Assoc 2015; 313: 2263–73.
  • 10. Ofosu A, Ramai D, Reddy M. Non-alcoholic fatty liver disease: Controlling an emerging epidemic, challenges, and future directions. Ann Gastroenterol 2018; 31: 288–95.
  • 11. Kostoglou-Athanassiou I, Gkountouvas A, Keramidas I, Xanthakou E, Chatjimarkou F, Kaldrymidis P. Lipid levels in acromegaly. In: Endocrine Abstracts 32. 2013. p. 172.
  • 12. Nikkilä EA, Pelkonen R. Serum lipids in acromegaly. Metabolism 1975; 24: 829–38.
  • 13. Marino L, Jornayvaz FR. Endocrine causes of nonalcoholic fatty liver disease. World J Gastroenterol 2015; 21: 11053–76.
  • 14. Vilar L, Naves L, Costa S, Abdalla L, Coelho C, Casulari L. Increase of Classic and Nonclassic Cardiovascular Risk Factors in Patients with Acromegaly Endocr Pract. 2013; 13: 363–72.
  • 15. Sesmilo G, Fairfield WP, Katznelson L et al. Cardiovascular risk factors in acromegaly before and after normalization of serum IGF-I levels with the GH antagonist pegvisomant. J Clin Endocrinol Metab 2002; 87: 1692–99.
  • 16. Ciresi A, Amato MC, Pizzolanti G, Giordano Galluzzo C. Visceral adiposity index is associated with insulin sensitivity and adipocytokine levels in newly diagnosed acromegalic patients. J Clin Endocrinol Metab 2012; 97: 2907–15.
  • 17. Freda PU, Shen W, Heymsfield SB et al. Lower visceral and subcutaneous but higher intermuscular adipose tissue depots in patients with growth hormone and insulin-like growth factor I excess due to acromegaly. J Clin Endocrinol Metab 2008; 93: 2334–43.
  • 18. Szendroedi J, Zwettler E, Schmid AI et al. Reduced basal ATP synthetic flux of skeletal muscle in patients with previous acromegaly. PLoS One 2008; 3: e3958.
  • 19. Wolf P, Winhofer Y, Krššák M, Krebs M. Heart, lipids and hormones. Endocr Connect 2017; 6: 59–69.
  • 20. Ichikawa T, Nakao K, Hamasaki K et al. Role of growth hormone, insulin-like growth factor 1 and insulin-like growth factor-binding protein 3 in development of non-alcoholic fatty liver disease. Hepatol Int 2007; 1: 287–94.
  • 21. Nishizawa H, Iguchi G, Murawaki A et al. Nonalcoholic fatty liver disease in adult hypopituitary patients with GH deficiency and the impact of GH replacement therapy. Eur J Endocrinol 2012; 167: 67–74.
  • 22. Kozakowski J, Rabijewski M, Zgliczynski W. Lowered ghrelin levels in acromegaly-normalization after treatment. Endokrynol Pol 2005; 56: 862–70.
  • 23. Dimopoulou C, Sievers C, Wittchen HU et al. Adverse anthropometric risk profile in biochemically controlled acromegalic patients: Comparison with an age- and gender-matched primary care population. Pituitary 2010; 13: 207–14.
  • 24. Hashimoto E, Tokushige K. Prevalence, gender, ethnic variations, and prognosis of NASH. J Gastroenterol 2011; 46: 63–9.
  • 25. Ratziua V, Bellentani S, Cortez-Pintoc H, Dayd C, Marchesinie G. A position statement on NAFLD/NASH based on the EASL 2009 special conference. J Hepatol 2010; 53: 372–84.

Fatty liver in patients with acromegaly

Yıl 2020, 2020 Özel Sayı, 33 - 38, 26.02.2020
https://doi.org/10.18663/tjcl.604304

Öz

Aim:
Patients
with acromegaly are at risk of metabolic diseases, such as diabetes mellitus,
insulin resistance and hypertriglyceridemia. We aimed to investigate what is
effective in the development of non-alcoholic fatty liver disease (NAFLD) in
patients with acromegaly.

Materials
and Methods:
60 (33 female, 27 male) patients with
acromegaly, and a healthy control group of 52 persons (27 female and 25 male)
were retrospectively studied. Mean age of the patients and the control group
were 44.11 ±13.83 and 39.12±14.99 respectively. Body mass index (BMI), liver
ultrasound and laboratory findings were taken from the records in the files.
Statistical analyzes were performed using SPSS statistical software package
version 22 (IBM Corporation, USA).

Results:
Fasting
blood sugar, triglyceride, insulin like growth factor, growth hormone(GH) and
CRP levels were significantly higher, HDL levels were significantly lower in
acromegaly group. BMI and NAFLD were similar between groups. We found that, BMI
and GH are the most important two factors in the presence of NAFLD in patients
with acromegaly. NAFLD correlates significantly positively with the patient's
BMI, weight and age; significantly negatively with the GH levels.







Conclusion:
In
people with acromegaly, BMI and GH levels are the things that affect
development of NAFLD.

Kaynakça

  • 1. Clemmons DR. Metabolic Actions of Insulin-Like Growth Factor-I in Normal Physiology and Diabetes. Endocrinol Metab Clin North Am 2012; 41: 425–43.
  • 2. Türkiye Endokrinoloji ve Metabolizma Derneği Hipofiz Çalışma Grubu. Hipofiz Hastalıkları Tanı, Tedavi ve İzlem Kılavuzu. ANKARA: 2018. p. 29–35.
  • 3. Rabinowitz D, Klassen GA, Zierler KL. Effect of Human Growth Hormone on Muscle and Adipose Tissue Metabolism. J Clin Invest 1965; 44: 51–61.
  • 4. Moøller N, Joørgensen JOL. Effects of growth hormone on glucose, lipid, and protein metabolism in human subjects. Endocr Rev 2009; 30: 152–77.
  • 5. Ciresi A, Guarnotta V, Campo D, Giordano C. Hepatic Steatosis Index in Acromegaly: Correlation with Insulin Resistance Regardless of the Disease Control. Int J Endocrinol. 2018; 5421961.
  • 6. Vijayakumar A, Novosyadlyy R, Wu YJ, Yakar S, LeRoith D. Biological effects of growth hormone on carbohydrate and lipid metabolism. Growth Horm IGF Res 2010; 20: 1–7.
  • 7. Colao A, Ferone D, Marzullo P, Lombardi G. Systemic Complications of Acromegaly: Epidemiology, Pathogenesis, and Management. Endocr Rev 2004; 25: 102–152.
  • 8. Alves-Bezerra M, Cohen D. Triglyceride Metabolism in the Liver. Compr Physiol 2017; 8: 1–8.
  • 9. Rinella ME. Nonalcoholic fatty liver disease a systematic review. JAMA - J Am Med Assoc 2015; 313: 2263–73.
  • 10. Ofosu A, Ramai D, Reddy M. Non-alcoholic fatty liver disease: Controlling an emerging epidemic, challenges, and future directions. Ann Gastroenterol 2018; 31: 288–95.
  • 11. Kostoglou-Athanassiou I, Gkountouvas A, Keramidas I, Xanthakou E, Chatjimarkou F, Kaldrymidis P. Lipid levels in acromegaly. In: Endocrine Abstracts 32. 2013. p. 172.
  • 12. Nikkilä EA, Pelkonen R. Serum lipids in acromegaly. Metabolism 1975; 24: 829–38.
  • 13. Marino L, Jornayvaz FR. Endocrine causes of nonalcoholic fatty liver disease. World J Gastroenterol 2015; 21: 11053–76.
  • 14. Vilar L, Naves L, Costa S, Abdalla L, Coelho C, Casulari L. Increase of Classic and Nonclassic Cardiovascular Risk Factors in Patients with Acromegaly Endocr Pract. 2013; 13: 363–72.
  • 15. Sesmilo G, Fairfield WP, Katznelson L et al. Cardiovascular risk factors in acromegaly before and after normalization of serum IGF-I levels with the GH antagonist pegvisomant. J Clin Endocrinol Metab 2002; 87: 1692–99.
  • 16. Ciresi A, Amato MC, Pizzolanti G, Giordano Galluzzo C. Visceral adiposity index is associated with insulin sensitivity and adipocytokine levels in newly diagnosed acromegalic patients. J Clin Endocrinol Metab 2012; 97: 2907–15.
  • 17. Freda PU, Shen W, Heymsfield SB et al. Lower visceral and subcutaneous but higher intermuscular adipose tissue depots in patients with growth hormone and insulin-like growth factor I excess due to acromegaly. J Clin Endocrinol Metab 2008; 93: 2334–43.
  • 18. Szendroedi J, Zwettler E, Schmid AI et al. Reduced basal ATP synthetic flux of skeletal muscle in patients with previous acromegaly. PLoS One 2008; 3: e3958.
  • 19. Wolf P, Winhofer Y, Krššák M, Krebs M. Heart, lipids and hormones. Endocr Connect 2017; 6: 59–69.
  • 20. Ichikawa T, Nakao K, Hamasaki K et al. Role of growth hormone, insulin-like growth factor 1 and insulin-like growth factor-binding protein 3 in development of non-alcoholic fatty liver disease. Hepatol Int 2007; 1: 287–94.
  • 21. Nishizawa H, Iguchi G, Murawaki A et al. Nonalcoholic fatty liver disease in adult hypopituitary patients with GH deficiency and the impact of GH replacement therapy. Eur J Endocrinol 2012; 167: 67–74.
  • 22. Kozakowski J, Rabijewski M, Zgliczynski W. Lowered ghrelin levels in acromegaly-normalization after treatment. Endokrynol Pol 2005; 56: 862–70.
  • 23. Dimopoulou C, Sievers C, Wittchen HU et al. Adverse anthropometric risk profile in biochemically controlled acromegalic patients: Comparison with an age- and gender-matched primary care population. Pituitary 2010; 13: 207–14.
  • 24. Hashimoto E, Tokushige K. Prevalence, gender, ethnic variations, and prognosis of NASH. J Gastroenterol 2011; 46: 63–9.
  • 25. Ratziua V, Bellentani S, Cortez-Pintoc H, Dayd C, Marchesinie G. A position statement on NAFLD/NASH based on the EASL 2009 special conference. J Hepatol 2010; 53: 372–84.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Özgün Makale
Yazarlar

Aynur Arslan 0000-0001-5968-5823

Emine Kartal Baykan 0000-0001-6813-883X

Nazligul Karauzum Yalcın 0000-0001-8170-1631

Mustafa Utlu 0000-0002-6148-6644

Havva Tugba Kıper Yılmaz 0000-0003-3072-7190

Alperen Akansel Caglar 0000-0001-8541-3418

Emre Deve 0000-0002-8840-4776

Emrah Dogan Bu kişi benim 0000-0003-4515-6626

Ayse Carlıoglu 0000-0002-5622-9563

Yayımlanma Tarihi 26 Şubat 2020
Yayımlandığı Sayı Yıl 2020 2020 Özel Sayı

Kaynak Göster

APA Arslan, A., Kartal Baykan, E., Karauzum Yalcın, N., Utlu, M., vd. (2020). Fatty liver in patients with acromegaly. Turkish Journal of Clinics and Laboratory, 11(1), 33-38. https://doi.org/10.18663/tjcl.604304
AMA Arslan A, Kartal Baykan E, Karauzum Yalcın N, Utlu M, Kıper Yılmaz HT, Caglar AA, Deve E, Dogan E, Carlıoglu A. Fatty liver in patients with acromegaly. TJCL. Şubat 2020;11(1):33-38. doi:10.18663/tjcl.604304
Chicago Arslan, Aynur, Emine Kartal Baykan, Nazligul Karauzum Yalcın, Mustafa Utlu, Havva Tugba Kıper Yılmaz, Alperen Akansel Caglar, Emre Deve, Emrah Dogan, ve Ayse Carlıoglu. “Fatty Liver in Patients With Acromegaly”. Turkish Journal of Clinics and Laboratory 11, sy. 1 (Şubat 2020): 33-38. https://doi.org/10.18663/tjcl.604304.
EndNote Arslan A, Kartal Baykan E, Karauzum Yalcın N, Utlu M, Kıper Yılmaz HT, Caglar AA, Deve E, Dogan E, Carlıoglu A (01 Şubat 2020) Fatty liver in patients with acromegaly. Turkish Journal of Clinics and Laboratory 11 1 33–38.
IEEE A. Arslan, E. Kartal Baykan, N. Karauzum Yalcın, M. Utlu, H. T. Kıper Yılmaz, A. A. Caglar, E. Deve, E. Dogan, ve A. Carlıoglu, “Fatty liver in patients with acromegaly”, TJCL, c. 11, sy. 1, ss. 33–38, 2020, doi: 10.18663/tjcl.604304.
ISNAD Arslan, Aynur vd. “Fatty Liver in Patients With Acromegaly”. Turkish Journal of Clinics and Laboratory 11/1 (Şubat 2020), 33-38. https://doi.org/10.18663/tjcl.604304.
JAMA Arslan A, Kartal Baykan E, Karauzum Yalcın N, Utlu M, Kıper Yılmaz HT, Caglar AA, Deve E, Dogan E, Carlıoglu A. Fatty liver in patients with acromegaly. TJCL. 2020;11:33–38.
MLA Arslan, Aynur vd. “Fatty Liver in Patients With Acromegaly”. Turkish Journal of Clinics and Laboratory, c. 11, sy. 1, 2020, ss. 33-38, doi:10.18663/tjcl.604304.
Vancouver Arslan A, Kartal Baykan E, Karauzum Yalcın N, Utlu M, Kıper Yılmaz HT, Caglar AA, Deve E, Dogan E, Carlıoglu A. Fatty liver in patients with acromegaly. TJCL. 2020;11(1):33-8.


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