Glucocorticoid Replacement for Adrenal Insufficiency and the Development of Non-Alcoholic Fatty Liver Disease
Glucocorticoid excess is a known risk factor for non-alcoholic fatty liver disease (NAFLD). Our objective was to analyse the impact of glucocorticoid replacement therapy on the development of NAFLD and NAFLD-related fibrosis and, therefore, on cardiovascular as well as hepatic morbidity in patients...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/19/6392 |
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| author | Gesine Meyer Madeleine Gruendl Irina Chifu Stefanie Hahner Johanna Werner Johannes Weiß Tina Kienitz Marcus Quinkler Klaus Badenhoop Eva Herrmann Mireen Friedrich-Rust Joerg Bojunga |
| author_facet | Gesine Meyer Madeleine Gruendl Irina Chifu Stefanie Hahner Johanna Werner Johannes Weiß Tina Kienitz Marcus Quinkler Klaus Badenhoop Eva Herrmann Mireen Friedrich-Rust Joerg Bojunga |
| author_sort | Gesine Meyer |
| collection | DOAJ |
| description | Glucocorticoid excess is a known risk factor for non-alcoholic fatty liver disease (NAFLD). Our objective was to analyse the impact of glucocorticoid replacement therapy on the development of NAFLD and NAFLD-related fibrosis and, therefore, on cardiovascular as well as hepatic morbidity in patients with adrenal insufficiency. Two hundred and fifteen individuals with primary (<i>n</i> = 111) or secondary (<i>n</i> = 104) adrenal insufficiency were investigated for hepatic steatosis and fibrosis using the fatty liver index (FLI), NAFLD fibrosis score (NAFLD-FS), Fibrosis-4 Index (FiB-4) plus sonographic transient elastography. Results were correlated with glucocorticoid doses and cardiometabolic risk parameters. The median dose of hydrocortisone equivalent was 20 mg daily, with a median therapy duration of 15 years. The presence and grade of hepatic steatosis and fibrosis were significantly correlated with cardiometabolic risk factors. We could not find any significant correlations between single, daily or cumulative doses of glucocorticoids and the grade of liver steatosis, nor with fibrosis measured via validated sonographic techniques. In patients with adrenal insufficiency, glucocorticoid replacement within a physiological range of 15–25 mg hydrocortisone equivalent per day does not appear to pose an additional risk for the development of NAFLD, subsequent liver fibrosis, or the cardiovascular morbidity associated with these conditions. |
| first_indexed | 2024-03-10T21:42:13Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T21:42:13Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-dcd75245d2f745589aa29411a7ec08332023-11-19T14:38:08ZengMDPI AGJournal of Clinical Medicine2077-03832023-10-011219639210.3390/jcm12196392Glucocorticoid Replacement for Adrenal Insufficiency and the Development of Non-Alcoholic Fatty Liver DiseaseGesine Meyer0Madeleine Gruendl1Irina Chifu2Stefanie Hahner3Johanna Werner4Johannes Weiß5Tina Kienitz6Marcus Quinkler7Klaus Badenhoop8Eva Herrmann9Mireen Friedrich-Rust10Joerg Bojunga11Division of Endocrinology, Medical Clinic 1, University Hospital, Goethe University Frankfurt, 60590 Frankfurt, GermanyDivision of Endocrinology, Medical Clinic 1, University Hospital, Goethe University Frankfurt, 60590 Frankfurt, GermanyEndocrinology and Diabetes Unit, Department of Medicine I, University Hospital Wuerzburg, 97080 Wuerzburg, GermanyEndocrinology and Diabetes Unit, Department of Medicine I, University Hospital Wuerzburg, 97080 Wuerzburg, GermanyEndocrinology and Diabetes Unit, Department of Medicine I, University Hospital Wuerzburg, 97080 Wuerzburg, GermanyDivision of Hepatology, Department of Medicine II, University Hospital Wuerzburg, 97080 Wuerzburg, GermanyEndocrinology in Charlottenburg, 10627 Berlin, GermanyEndocrinology in Charlottenburg, 10627 Berlin, GermanyDivision of Endocrinology, Medical Clinic 1, University Hospital, Goethe University Frankfurt, 60590 Frankfurt, GermanyInstitut for Biostatistics and Mathematic Modelling, Goethe University Frankfurt, 60590 Frankfurt, GermanyDivision of Hepatology, Medical Clinic 1, University Hospital, Goethe University Frankfurt, 60590 Frankfurt, GermanyDivision of Endocrinology, Medical Clinic 1, University Hospital, Goethe University Frankfurt, 60590 Frankfurt, GermanyGlucocorticoid excess is a known risk factor for non-alcoholic fatty liver disease (NAFLD). Our objective was to analyse the impact of glucocorticoid replacement therapy on the development of NAFLD and NAFLD-related fibrosis and, therefore, on cardiovascular as well as hepatic morbidity in patients with adrenal insufficiency. Two hundred and fifteen individuals with primary (<i>n</i> = 111) or secondary (<i>n</i> = 104) adrenal insufficiency were investigated for hepatic steatosis and fibrosis using the fatty liver index (FLI), NAFLD fibrosis score (NAFLD-FS), Fibrosis-4 Index (FiB-4) plus sonographic transient elastography. Results were correlated with glucocorticoid doses and cardiometabolic risk parameters. The median dose of hydrocortisone equivalent was 20 mg daily, with a median therapy duration of 15 years. The presence and grade of hepatic steatosis and fibrosis were significantly correlated with cardiometabolic risk factors. We could not find any significant correlations between single, daily or cumulative doses of glucocorticoids and the grade of liver steatosis, nor with fibrosis measured via validated sonographic techniques. In patients with adrenal insufficiency, glucocorticoid replacement within a physiological range of 15–25 mg hydrocortisone equivalent per day does not appear to pose an additional risk for the development of NAFLD, subsequent liver fibrosis, or the cardiovascular morbidity associated with these conditions.https://www.mdpi.com/2077-0383/12/19/6392adrenal insufficiencyglucocorticoid replacementnon-alcoholic fatty liver diseaseelastographyhepatic steatosishepatic fibrosis |
| spellingShingle | Gesine Meyer Madeleine Gruendl Irina Chifu Stefanie Hahner Johanna Werner Johannes Weiß Tina Kienitz Marcus Quinkler Klaus Badenhoop Eva Herrmann Mireen Friedrich-Rust Joerg Bojunga Glucocorticoid Replacement for Adrenal Insufficiency and the Development of Non-Alcoholic Fatty Liver Disease Journal of Clinical Medicine adrenal insufficiency glucocorticoid replacement non-alcoholic fatty liver disease elastography hepatic steatosis hepatic fibrosis |
| title | Glucocorticoid Replacement for Adrenal Insufficiency and the Development of Non-Alcoholic Fatty Liver Disease |
| title_full | Glucocorticoid Replacement for Adrenal Insufficiency and the Development of Non-Alcoholic Fatty Liver Disease |
| title_fullStr | Glucocorticoid Replacement for Adrenal Insufficiency and the Development of Non-Alcoholic Fatty Liver Disease |
| title_full_unstemmed | Glucocorticoid Replacement for Adrenal Insufficiency and the Development of Non-Alcoholic Fatty Liver Disease |
| title_short | Glucocorticoid Replacement for Adrenal Insufficiency and the Development of Non-Alcoholic Fatty Liver Disease |
| title_sort | glucocorticoid replacement for adrenal insufficiency and the development of non alcoholic fatty liver disease |
| topic | adrenal insufficiency glucocorticoid replacement non-alcoholic fatty liver disease elastography hepatic steatosis hepatic fibrosis |
| url | https://www.mdpi.com/2077-0383/12/19/6392 |
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