"Endocrine NAFLD": a hormonocentric perspective of Non-Alcoholic Liver Disease (NAFLD) pathogenesis in HIV-infected patients

Purpose of the study

We assessed endocrine system involvement in a multifactorial pathogenesis hypothesis of NAFLD in HIV-infected patients.

Methods

Cross-sectional observational study including all consecutive HIV-infected patients seen at a metabolic clinic who were screened for diabetes, thyroid dysfunction, male hypogonadism, female menopause, hypopituitarism. NAFLD was defined by liver-spleen attenuation values of ≤1.1 on computed tomography.

Summary of results

225 patients were included. (Table 1.)

Table 1

We included endocrine variables (but not sex hormones) and known independent predicting variables (sex, waist circumference, ALT/AST, NRTI cumulative exposure) in a backward stepwise multivariate logistic regression analysis. Independent variables associated with NAFLD were NRTI cumulative exposure (OR = 1.11 per year; CI 1.01–1.20), ALT/AST (OR = 3.97; CI 1.78–8.87), waist circumference (OR = 1.06; CI 1.03–1.11). When including sex hormones in different gender groups insulin increased predictive value in female only (OR = 1.18; CI 1.03, 1.34).

Conclusion

Homeostasis of glucose appears the only endocrine system associated with NAFLD.