Endocrine Abstracts

JOINT1141

Introduction: Acromegaly is a disorder characterized by excessive secretion of growth hormone (GH), leading to increased insulin-like growth factor-1 (IGF-1) levels. Nonalcoholic fatty liver disease (NAFLD), a significant global health concern, is considered the hepatic manifestation of metabolic syndrome and may progress to fibrosis, cirrhosis, or hepatocellular carcinoma. The noninvasive test fibrosis-4 (FIB-4) score are the commonly used and recommended hepatic fibrosis scores for screening liver fibrosis. FIB-4 upper cut-off of < 1.3 suggests better diagnostic accuracy for predicting NAFLD. Nuclear factor kappa B (NF-κB) activation may contribute to insulin resistance and metabolic syndrome-related pathologies, including hepatic steatosis in acromegalic patients. This study aims to investigate the inflammatory processes in acromegalic patients with hepatosteatosis and controls to determine NF-κB levels in both conditions.

Methods: A total of thirty participants, including sixteen acromegalic patients and fourteen controls, will be included. We obtained demographic data, hormonal and metabolic parameters, and abdomen ultrasonography (USG) reports. NF-κB levels were measured using ELISA.

Results: The median age and gender distribution of the study participants were similar across groups (P >0.05). Among the clinical parameters, there were significant differences in the mean values of fasting insulin (P = 0.002), GH (P = 0.049), IGF-1 (P <0.001), and FIB-4 (P = 0.001), with higher values observed in acromegaly patients. In univariate logistic regression analysis, fasting insulin was found to increase the risk of acromegaly (O r = 2.76; 95% CI [1.032-7.380]), and FIB-4 was also identified as a risk factor (P = 0.009). In the multivariate analysis, FIB-4 remained a significant risk factor (P = 0.009). ROC analysis for distinguishing between acromegaly and control group revealed that fasting insulin had an AUC of 0.833 (sensitivity=68%, specificity=92%), while FIB-4 had an AUC of 0.821 (sensitivity=76%, specificity=93%). In sensitivity analyses, the acromegaly group was evaluated as controlled and uncontrolled. When comparing the mean FIB-4 values among the three groups, a significant difference was observed (P = 0.005). Post-hoc comparisons revealed significant differences between the healthy and controlled acromegaly groups (P <0.001) as well as between the healthy and uncontrolled acromegaly groups (P <0.001). The median NFKB levels were similar between the healthy and acromegaly groups (P = 0.339). No significant difference was detected when comparing NFKB medians among the three groups (P = 0.539).

Conclusion: This study is the first study to investigate NF-κB levels in acromegalic patients with hepatosteatosis, highlighting its potential role in metabolic dysfunction and hepatic inflammation. FIB-4 was identified as a risk factor to increase the risk of acromegaly. No significant difference was detected when comparing NFKB.