Risk Factors for MAFLD and Advanced Liver Fibrosis in Adult-Onset Craniopharyngioma Patients: A Cross-Sectional Study

Lijiao Chen, Wei Wu, Hongying Ye Department of Endocrinology, Huashan Hospital, Fudan University, Shanghai, 200040, People’s Republic of ChinaCorrespondence: Hongying Ye, Department of Endocrinology, Huashan Hospital, Fudan University, No. 12 Wulumuqi Road (Middle), Shanghai, 200040, People’s Republic of China, Email [email protected]: To investigate the prevalence of and risk factors for metabolic dysfunction-associated fatty liver disease (MAFLD) and advanced liver fibrosis (ALF) in postoperative adult-onset craniopharyngioma (AOCP) patients.Patients and Methods: This cross-sectional study included 242 postoperative AOCP patients at Huashan Hospital (Shanghai, China). Clinical characteristics were compared between patients with and without MAFLD and ALF. Independent risk factors for MAFLD and ALF were identified using binary logistic regression analysis.Results: The prevalence of MAFLD in postoperative AOCP patients was 67.4% (95% CI 61.2– 73.0%), and 32.5% (95% CI 25.8– 40.0%) of patients with MAFLD were diagnosed with ALF. Body mass index (BMI) was independently associated with MAFLD (OR = 1.51, 95% CI 1.33– 1.72, P < 0.001). In patients with MAFLD, hypertension (OR = 2.33, 95% CI 1.04– 5.20, P = 0.040), glycated hemoglobin (HbA1c) (OR = 1.34, 95% CI 1.01– 1.78, P = 0.044), daily hydrocortisone dose (OR = 1.08, 95% CI 1.01– 1.15, P = 0.026), and insulin-like growth factor-1 (IGF-1)(OR = 0.99, 95% CI 0.97– 0.99, P = 0.011) were independently associated with the presence of ALF.Conclusion: MAFLD is a common comorbidity in postoperative AOCP patients and is associated with a high risk of ALF. MAFLD is closely related to BMI, while ALF is significantly associated with hypertension, HbA1c levels, IGF-1 levels, and daily hydrocortisone dose. Strategies such as controlling weight gain, maintaining optimal blood glucose and blood pressure levels, appropriate hormone replacement, and avoiding excessive glucocorticoid use should be implemented to prevent and delay the onset and progression of MAFLD and ALF.Keywords: craniopharyngioma, adult-onset, hypopituitarism, metabolic dysfunction-associated fatty liver disease, advanced liver fibrosis