In our latest blog Dr Jake Mann tells us about a new study which is being planned to look into non-alcoholic fatty liver disease.
One of the most common brain tumours affecting children (called a craniopharyngioma) is a slow growing tumour that can be completely cured by removing it during an operation or by treating it with radiotherapy. However, it is located in an important part of the brain that controls appetite and hormone levels. After treatment for this type of tumour, children can become very overweight ('obese') and store excess fat in their liver ('fatty liver').
There is evidence that after treatment these children can get very severe fatty liver, which in extreme cases can cause liver failure which requires a transplant. This happens much more quickly than expected: a lot faster than in obese children with fatty liver who have not had brain surgery. We do not know just how many children have fatty liver after this brain surgery. We also don't know why, when they do develop this complication, it gets worse so quickly.
Our research project will be carried out in two parts. Firstly we will use blood tests and an ultrasound scan to look for fatty livers in patients who have had this type of brain surgery as a child. We will then ask a small group of patients with and without liver disease (plus some children with fatty liver but who have not had surgery) to undergo more detailed blood tests, an overnight stay in hospital and two additional scans. This will let us study the chemical and nerve signals that might cause the aggressive fatty liver.
This study will help us to understand how to monitor the livers of children who have had this kind of brain surgery or radiotherapy. It will also let us warn children and their parents of the risk to their liver before the surgery to remove the tumour happens. If we find a specific change in hormones or nerve signals then this could lead to an improvement in how we treat these children. It could also give us clues about how and why others, who haven't had surgery, develop non-alcoholic fatty liver disease.
The full title of the study is: "The pathophysiology of non-alcoholic fatty liver disease in patients with childhood-acquired hypothalamic insufficiency" and the principal investigator is Prof. David Dunger from The University of Cambridge.