Increased risk of steatotic liver disease, major adverse liver outcomes, cardiovascular events, and mortality in pheochromocytoma: a model of chronically elevated sympathetic tone
Main finding · Incident MASLDResult — go to the resultHazard ratio 1.48 95% CI 1.38–1.58Authors' conclusion
PPGL was associated with increased risk of MASLD, progressive liver complications, MACE, and mortality, supporting a link between chronic catecholamine excess and adverse hepatic outcomes.
Study context
- Population
- Adults with pheochromocytoma and paraganglioma (PPGL) or essential hypertension, defined using ICD-10 codes/anthropometry, TriNetX Network; matched for demographic, metabolic and blood pressure-related variablesmatched cohort
- Participants
- 45,595 vs 45,595
- Exposure
- PPGL vs essential hypertension
- PPGLn = 45,595
- Essential hypertensionn = 45,595reference
- Outcome
- Time to incident MASLD
- Follow-up
- 5 years from index diagnosis
Methodological detailspropensity score matched (1:1), TriNetX Network
- Propensity score matched (1:1)
- TriNetX Network
Main finding
Incident MASLD
Hazard ratio
1.48
95% CI 1.38–1.58
PPGLvs Essential hypertension
HR 1.48 (95% CI 1.38–1.58)
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| MALO · 5 yearsPropensity score matched | 1.59 (1.44–1.76) | |
| Hepatic decompensation · 5 yearsPropensity score matched | 1.73 (1.53–1.95) | |
| Hepatocellular carcinoma · 5 yearsPropensity score matched | 2.18 (1.70–2.80) | |
| 0.20.5125Hazard ratio (log scale) |
Major adverse cardiovascular events (MACE) · 5 years
- A modest increase in MACE was observed (HR; 95% CI)
- HR 1.13; 1.09-1.16
- Propensity score matched
Incident T2D · 5 years
- Incident T2D risk was not significantly different (HR; 95% CI)
- HR 1.02; 0.98-1.06
- Propensity score matched
Cardiometabolic risk by subgroup
- Pheochromocytoma and PPGL treated with α-adrenergic blockade demonstrated greatest cardiometabolic risk
Original publication
Increased risk of steatotic liver disease, major adverse liver outcomes, cardiovascular events, and mortality in pheochromocytoma: a model of chronically elevated sympathetic tone. Eur J Endocrinol. Published 17 September 2026. doi:10.
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