In a case-control study of German patients with biochemically controlled Cushing's disease due to ACTH-secreting pituitary tumor (n = 33) and controls with non-functioning pituitary adenomas (n = 79), hepatic steatosis (non-invasively evaluated with the Fatty Liver Index [FLI] > 60) was present in 30.3% of patients with Cushing’s disease (non-treatment naïve), which was not statistically different compared with the prevalence of hepatic steatosis observed in those with non-functioning pituitary adenomas (20.3%). Here, POMC is linked to fatty liver disease.