Endocrine status of adolescent girls with non-alcoholic fatty liver disease and obesity
DOI:
https://doi.org/10.12775/JEHS.2020.10.06.045Keywords
girls, puberty, obesity, nonalcoholic fatty liver disease, endocrine statusAbstract
Along with the increase in the prevalence of childhood obesity, diseases associated with unhealthy morbid obesity, including non-alcoholic fatty liver disease (NAFLD), are also on the rise. How NAFLD affects the hormonal profile in adolescent girls has not been studied enough. Therefore, the aim of this study was to examine the features of the endocrine status of adolescent girls with NAFLD and obesity. Material and methods. From 2010 to 2020, 300 patients aged 12–17 years were monitored, including 120 patients with NAFLD and metabolically unhealthy obesity and 180 conditionally somatically healthy girls with normal sexual development with normal body weight. Clinical examination, biochemical assessment of the functional state of the liver and its morphostructure were performed. Determination of the level of peripheral blood serum hormones was performed by immunochemical method with chemiluminescent detection. Results. Endocrine status of girls with NAFLD and obesity was characterized by an increase in luteinizing hormone (LH) - 9.89 ± 0.18 vs. 5.13 ± 0.08 μIU / ml (p<0.01); follicle-stimulating hormone (FSH) - 5.50 ± 0.16 vs. 5.40 ± 0.07 μIU / ml (p<0.01); the ratio of LH / FSH - 1.91 ± 0.05 vs. 0.98 ± 0.02 (p<0.01); prolactin - 327.73 ± 7.15 vs. 282.93 ± 8.36 μIU / ml (p<0.01); thyroid-stimulating hormone (TSH) - 3.36 ± 0.07 vs. 2.15 ± 0.05 μIU / ml (p<0.01); decrease in estradiol level - 124.15 ± 2.39 vs. 437.45 ± 9.59 pmol / ml (p<0.01); progesterone - 1.49 ± 0.09 vs. 2.78 ± 0.08 nmol / ml (p<0.01); increase in the level of free testosterone - 1.96 ± 0.10 vs. 1.16 ± 0.04 nmol / l (p <0.01); free triiodothyronine - 4.41 ± 0.12 vs. 5.46 ± 0.07 pmol / l (p<0.01); free thyroxine - 14.61 ± 0.41 vs. 18.55 ± 0.20 pmol / l (p<0.01). Conclusions. Endocrine status of girls with NAFLD and unhealthy morbid obesity during puberty is characterized by increased secretion of gonadotropins, prolactin and TSH, decreased levels of estradiol, progesterone, thyroid hormones against the background of a moderate increase of androgens, insulin and insulin resistance.
References
Bokova TA. Metabolic syndrome in children: approaches to prevention and pathogenetic therapy. Attending doctor. 2018;9:74-76. [In Russian]
Bokova TA. Non-alcoholic fatty liver disease in obese children with metabolic syndrome. Attending doctor. 2019;1:28-31. [In Russian]
Borshulyak AA, Bodnaryuk OI, Andriyets OA. Aspects of the development of menstrual disorders in overweight girls. Obstetrics. Gynecology. Genetics. 2017;3(3):47-52. [In Russian]
Buzzetti E, Pinzani M, Tsochatzis EA. The multiple-hit pathogenesis of non-alcoholic fatty liver disease (NAFLD). Metabolism. 2016 Aug;65(8):1038-48. doi: 10.1016/j.metabol.2015.12.012.
D'Adamo E, Castorani V, Nobili V. The Liver in Children With Metabolic Syndrome. Front Endocrinol (Lausanne). 2019 Aug 2;10:514. doi: 10.3389/fendo.2019.00514.
Della Torre S. Non-alcoholic Fatty Liver Disease as a Canonical Example of Metabolic Inflammatory-Based Liver Disease Showing a Sex-Specific Prevalence: Relevance of Estrogen Signaling. Front Endocrinol (Lausanne). 2020 Sep 18;11:572490. doi: 10.3389/fendo.2020.572490.
Engin A. Non-Alcoholic Fatty Liver Disease. Adv Exp Med Biol. 2017;960:443-467. doi: 10.1007/978-3-319-48382-5_19.
Farrell GC, Haczeyni F, Chitturi S. Pathogenesis of NASH: How Metabolic Complications of Overnutrition Favour Lipotoxicity and Pro-Inflammatory Fatty Liver Disease. Adv Exp Med Biol. 2018;1061:19-44. doi: 10.1007/978-981-10-8684-7_3.
Friedman SL, Neuschwander-Tetri BA, Rinella M, Sanyal AJ. Mechanisms of NAFLD development and therapeutic strategies. Nat Med. 2018 Jul;24(7):908-922. doi: 10.1038/s41591-018-0104-9.
Gadde KM, Martin CK, Berthoud HR, Heymsfield SB. Obesity: Pathophysiology and Management. J Am Coll Cardiol. 2018 Jan 2;71(1):69-84. doi: 10.1016/j.jacc.2017.11.011.
Harding KL, Aguayo VM, Webb P. Trends and Correlates of Overweight among Pre-School Age Children, Adolescent Girls, and Adult Women in South Asia: An Analysis of Data from Twelve National Surveys in Six Countries over Twenty Years. Nutrients. 2019 Aug 14;11(8):1899. doi: 10.3390/nu11081899.
Mann JP, De Vito R, Mosca A, Alisi A, Armstrong MJ, Raponi M, Baumann U, Nobili V. Portal inflammation is independently associated with fibrosis and metabolic syndrome in pediatric nonalcoholic fatty liver disease. Hepatology. 2016 Mar;63(3):745-53. doi: 10.1002/hep.28374.
Mann JP, Valenti L, Scorletti E, Byrne CD, Nobili V. Nonalcoholic fatty liver disease in children. Semin Liver Dis. 2018 Feb;38(1):1-13. doi: 10.1055/s-0038-1627456.
Marino L, Jornayvaz FR. Endocrine causes of nonalcoholic fatty liver disease. World J Gastroenterol. 2015 Oct 21;21(39):11053-76. doi: 10.3748/wjg.v21.i39.11053.
Mikolasevic I, Milic S, Turk Wensveen T, Grgic I, Jakopcic I, Stimac D, Wensveen F, Orlic L. Nonalcoholic fatty liver disease - A multisystem disease? World J Gastroenterol. 2016 Nov 21;22(43):9488-9505. doi: 10.3748/wjg.v22.i43.9488.
Mistry S, Puthussery S. Risk factors of overweight and obesity in childhood and adolescence in South Asian countries: A systematic review of the evidence. Public Health. 2015 Mar; 129(3):200-209. doi: 10.1016/j.puhe.2014.12.004.
Moskovkina AV, Puzikova OZ, Linde VA, Rybiskaya NP. Hyperprolactinemia in adolescent girls with hyperandrogenism. Children's Hospital. 2013;2:34-39. [In Russian]
Mota M, Banini BA, Cazanave SC, Sanyal AJ. Molecular mechanisms of lipotoxicity and glucotoxicity in nonalcoholic fatty liver disease. Metabolism. 2016 Aug;65(8):1049-61. doi: 10.1016/j.metabol.2016.02.014.
Polyzos SA, Kountouras J, Mantzoros CS. Leptin in nonalcoholic fatty liver disease: a narrative review. Metabolism. 2015 Jan;64(1):60-78. doi: 10.1016/j.metabol.2014.10.012.
Portillo-Sanchez P, Bril F, Maximos M, Lomonaco R, Biernacki D, Orsak B, Subbarayan S, Webb A, Hecht J, Cusi K. High Prevalence of Nonalcoholic Fatty Liver Disease in Patients With Type 2 Diabetes Mellitus and Normal Plasma Aminotransferase Levels. J Clin Endocrinol Metab. 2015 Jun;100(6):2231-8. doi: 10.1210/jc.2015-1966.
Rosenfield RL, Bordini B. Evidence that obesity and androgens have independent and opposing effects on gonadotropin production from puberty to maturity. Brain Res. 2010 Dec 10;1364:186-97. doi: 10.1016/j.brainres.2010.08.088.
Samperi I, Lithgow K, Karavitaki N. Hyperprolactinaemia. J Clin Med. 2019 Dec 13;8(12):2203. doi: 10.3390/jcm8122203.
Schiffer L, Barnard L, Baranowski ES, Gilligan LC, Taylor AE, Arlt W, Shackleton CHL, Storbeck KH. Human steroid biosynthesis, metabolism and excretion are differentially reflected by serum and urine steroid metabolomes: A comprehensive review. J Steroid Biochem Mol Biol. 2019 Nov;194:105439. doi: 10.1016/j.jsbmb.2019.105439
Schuster S, Cabrera D, Arrese M, Feldstein AE. Triggering and resolution of inflammation in NASH. Nat Rev Gastroenterol Hepatol. 2018 Jun;15(6):349-364. doi: 10.1038/s41575-018-0009-6.
Selvakumar PKC, Kabbany MN, Nobili V, Alkhouri N. Nonalcoholic Fatty Liver Disease in Children: Hepatic and Extrahepatic Complications. Pediatr Clin North Am. 2017 Jun;64(3):659-675. doi: 10.1016/j.pcl.2017.01.008.
Styne DM, Arslanian SA, Connor EL, Farooqi IS, Murad MH, Silverstein JH, Yanovski JA. Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2017 Mar 1;102(3):709-757. doi: 10.1210/jc.2016-2573.
Suzuki A, Abdelmalek MF, Schwimmer JB, Lavine JE, Scheimann AO, Unalp-Arida A, Yates KP, Sanyal AJ, Guy CD, Diehl AM; Nonalcoholic Steatohepatitis Clinical Research Network. Association between puberty and features of nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2012 Jul;10(7):786-94. doi: 10.1016/j.cgh.2012.01.020.
Terrault NA, Lok ASF, McMahon BJ, Chang KM, Hwang JP, Jonas MM, Brown RS Jr, Bzowej NH, Wong JB. Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance. Clin Liver Dis (Hoboken). 2018 Aug 22;12(1):33-34. doi: 10.1002/cld.728.
Youssef J, Badr MZ. PPARs: history and advances. Methods Mol Biol. 2013;952:1-6. doi: 10.1007/978-1-62703-155-4_1.
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