Cytokeratin 18: An early biomarker of increased liver fibrosis in newly diagnosed acromegaly

Meric Coskun; Sendur Halit Nahit; Afruz Babayeva; Cerit Mahi Nur; Cerit Ethem Turgay; yalcin Mehmet Muhittin; Altinova Alev Eroglu; Mujde Akturk; Karakoc Mehmet Ayhan; Toruner Fusun Balos

doi:10.1530/endoabs.99.P516

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Endocrine Abstracts (2024) 99 P516 | DOI: 10.1530/endoabs.99.P516

ECE2024 Poster Presentations Pituitary and Neuroendocrinology (120 abstracts)

Cytokeratin 18: An early biomarker of increased liver fibrosis in newly diagnosed acromegaly

Meric Coskun ¹ , Halit Nahit Sendur ² , Afruz Babayeva ¹ , Mahi Nur Cerit ² , Ethem Turgay Cerit ¹ , Mehmet Muhittin yalcin ¹ , Alev Eroglu Altinova ¹ , Mujde Akturk ¹ , Mehmet Ayhan Karakoc ¹ & Fusun Balos Toruner ¹

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¹Gazi University, Faculty of Medicine, Endocrinology and Metabolism, Ankara, Turkey; ²Gazi University, Faculty of Medicine, Radiology, Ankara, Turkey

Purpose: The liver is known to be protected from steatosis under the influence of high GH/IGF-1. Cytokeratin 18 (CK18) and insulin-like growth factor binding protein 7 (IGFBP7) increase in liver steatosis and fibrosis. Whether decreasing lipid content completely protects the liver from metabolic alterations and the response of CK18 and IGFBP7 to liver changes in acromegaly is unknown.

Methods: This single-center, multidisciplinary, cross-sectional study included 23 patients with newly diagnosed acromegaly and 46 age, sex, body mass index (BMI) and waist circumference (WC)-matched healthy controls. Liver steatosis was assessed using tissue attenuation imaging (TAI), and stiffness, indicative of fibrosis, was assessed using shear wave elastography (SWE). Serum IGFBP7 and CK18 were studied by ELISA.

Results: The acromegaly group had significantly lower liver steatosis (P=0.006) and higher liver stiffness (P=0.004), serum IGFBP7 (P=0.048) and CK18 (P=0.005) levels than the control group. The presence of fibrosis (P=0.012) was significantly higher in the acromegaly group than in the control group. Moreover, CK18 was positively correlated with liver stiffness, WC, HOMA-IR, HbA1c, and triglyceride. In the acromegaly group, liver steatosis was negatively correlated with GH level. Stepwise multiple linear regression analysis revealed that BMI (P=0.008) and CK18 (P=0.015) were independent risk factors for increased liver stiffness.

Conclusion: This study showed that newly diagnosed acromegaly had low hepatic steatosis with a protective effect of GH, and metabolic changes caused an increase in liver fibrosis. Additionally, elevated CK18 in patients with acromegaly may be an early biomarker of increased liver fibrosis due to metabolic alterations.