The Link Between Acromegaly, Liver Morphology, and MASLD: A Large Cohort Analysis

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ID: 325498
2026
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Abstract
OBJECTIVE: To evaluate liver morphology and clinical determinants in acromegaly. DESIGN: Retrospective single-center cohort study. METHODS: We analyzed 394 acromegaly patients followed at a single tertiary center over four decades for hepatic morphology and metabolic dysfunction-associated steatotic liver disease (MASLD). Patients were compared by hepatic cyst and MASLD status; multivariable logistic regression identified independent predictors, using outcome-specific primary hormonal exposures-the peri-imaging IGF1×ULN for MASLD and time-weighted-average IGF1×ULN (TWAvg) for hepatic cysts. Standardized prevalence ratios (SPR) against age- and sex-stratified references were also examined. RESULTS: Of 282 imaged patients, MASLD, hepatic cyst, hemangioma, and cholelithiasis prevalence was 31.0%, 15.6%, 4.3%, and 36.8%. Cyst prevalence matched population estimates, whereas imaging-detected MASLD was significantly lower than expected (SPR 0.56-0.78). Hepatic cyst was independently associated with renal cyst (OR 2.769) and inversely with MASLD (0.231), with older age borderline significant. MASLD was inversely associated with the peri-imaging IGF1×ULN (OR 0.74 per doubling), hepatic cyst (0.109), and longitudinal exposure (log2 TWAvg IGF1×ULN 0.61), and positively with cholelithiasis (3.158). CONCLUSIONS: Hepatic cyst prevalence matched population estimates, whereas imaging-detected MASLD was significantly lower. Cysts associated with older age, renal cysts, and absence of MASLD; MASLD associated inversely with the peri-imaging and longitudinal IGF1 exposure and positively with cholelithiasis. The inverse cyst-MASLD relationship is hypothesis-generating: MASLD tracked GH/IGF1 activity whereas cysts did not, suggesting distinct hepatic phenotypes of a shared, as-yet-unmeasured determinant rather than opposite readouts of one hormonal signal.
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openalex_W7203741561 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Polat Ercan, Büşra Fırlatan Yazgan, Süleyman Nahit Şendur, Selçuk Dağdelen, Tomris Erbaş
Journal european journal of endocrinology
Year 2026
DOI
10.1093/ejendo/lvag159
URL
Keywords Keywords not found

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