SUN-024 Characterization and Prevalence of Non-alcoholic Fatty Liver Disease and Fibrosis in Growth Hormone Deficient Sheehan Syndrome patients.

Abstract S. Mir: None. B. Dar: None. P. Sharma: None. Background: Sheehan syndrome (SS) is a condition that occurs due to the loss of blood to the pituitary during parturition. Liver dysfunction in adult hypopituitary patients with GH deficiency (GHD) and an increased prevalence of non-alcoholic fatty liver disease (NAFLD) has been reported early. There is a limited number of studies that have investigated the association between Sheehan syndrome and liver dysfunction or non-alcoholic fatty liver disease (NAFLD), however, hypopituitary patients with growth hormone deficiency have an increased prevalence of non-alcoholic liver disease and fibrosis. Objective: The present study intended to see the prevalence of liver dysfunction and NAFLD in Sheehan syndrome patients on a long-term follow-up which is one of the common causes of hypopituitarism in our country. Material and Methods: A total of 105 subjects were enrolled in present study, out of which 61 patients were Sheehan syndrome on long-term follow-up in our department for more than 10 years and 44 were age-matched and BMI-matched controls. Only 53 patients were finally taken for study who had confirmed growth hormone deficiency by ITT and IGF1 Levels. The prevalence of NAFLD was assessed by liver function tests and Fibroscan. Insulin resistance was measured by the homeostasis assessment formula (HOMA IR).TNF alpha, IL-6 & Leptin levels were measured in cases and controls. All Patients were on a standard replacement for panhypopituitarism except growth hormone. Patients were compared with BMI-matched controls. Results: NAFLD occurs more frequently in Sheehan syndrome patients than in controls (66 vs. 28%, P 0.001). Fibroscan showed some form of steatosis in 66 percent of patients with a mean CAP of 274 ± 66.3 with a significant degree of moderate and severe steatosis in cases than controls. No significant fibrosis was seen in cases and controls (mean LSM of 5.2 ± 3.2 kPa). Insulin & HOMA-IR was significantly more in cases than controls (3.2 vs 1.6) ( p-value of 0.005). Serum TNF alpha, IL-6 and Leptin were significantly more in Sheehan syndrome patients as compared to controls but only Leptin, BMI & HOMA-IR showed a positive correlation with steatosis. Conclusions: Sheehan syndrome patients have a higher prevalence of NAFLD. Sheehan syndrome patients have a higher prevalence of inflammatory markers but showed no correlation with hepatic steatosis and fibrosis. Further studies are needed to look at the long-term effects of growth hormone deficiency on liver disease. Key Words: Sheehan syndrome, NAFLD, Leptin. Sunday, June 2, 2024