Endocrine Abstracts

Introduction: Liver Steatosis(LS) can be one of the metabolic complications of Cushing Syndrome(CS). The data on the impact of cortisol on liver function are very limited, and there is only one study reporting a prevalence of LS of roughly 20%. Hepatic Steatosis Index (HSI) predicts LS based on ALT, AST, BMI, sex and co-existence of diabetes mellitus/impaired glucose intolerance.

Objectives: To evaluate the prevalence of LS in patients with CS at the time of diagnosis by using HSI.

Methods: We analyzed retrospectively adult patients from the ERCUSyN, Krakow database with complete HSI data available. 82 of 135 patients, aged 27-87 years, predominantly women (n=64), were eligible for the study. The HSI score was calculated using the following formula: 8× (ALT/AST)+BMI+2(if type 2 diabetes)+2(if female). Collected data were from the baseline CS diagnosis. Patients with score 36 or above were classified as having a high probability of LS. We compared HSI results with the liver steatosis diagnosed based on abdominal ultrasonography (USG) findings, clinical and demographic factors.

Results: High HSI was observed in 81.7% patients (82.8% of females, 77.8% of males). HSI was elevated in 85%, 80% and 73% of patients with pituitary, adrenal and ectopic CS respectively. 41% of patients with elevated HSI were obese. HSI was elevated in among: 100% patients with confirmed liver steatosis on USG, 72% patients with normal USG and 78% patients who did not undergo USG. Conclusions: The prevalence of liver steatosis in active CS may be higher than previously reported. Further investigation should be undertaken to show if patients with high risk of LS based on HSI and normal liver image on USG, may benefit from liver MRI in order to confirm the diagnosis.