TY - JOUR
T1 - Hepatic steatosis, GH deficiency and the effects of GH replacement
T2 - A Liverpool magnetic resonance spectroscopy study
AU - Gardner, Chris J.
AU - Irwin, Andrew J.
AU - Daousi, Christina
AU - McFarlane, Ian A.
AU - Joseph, Franklin
AU - Bell, Jimmy D.
AU - Thomas, E. Louise
AU - Adams, Valerie L.
AU - Kemp, Graham J.
AU - Cuthbertson, Daniel J.
PY - 2012/6
Y1 - 2012/6
N2 - Objective: Non-alcoholic fatty liver disease (NAFLD) is reported to be more common in patients with GH deficiency (GHD) than in the general population. We aimed to determine: i) liver fat in patients with GHD compared with age and body mass index (BMI)-matched controls; and ii) effect of 6 months of GH replacement (GHR) on liver fat. Participants and methods: The study included 28 GHD patients and 24 controls. 12 patients were studied before and after 6 months of GHR. Anthropometry, liver enzymes and lipid profiles were measured, and body composition and intrahepatocellular lipid (IHCL) were determined by magnetic resonance imaging and spectroscopy. Results: Age and BMI (median (inter-quartile range)) of patients and controls were 52.6 (14) vs 52.6 (12) years (P = 0.9) and 27.8 (24.7, 34.7) vs 27.9 (25.1, 32.1) kg/m 2 (P = 0.9). IGF1 was lower in the patients (11.5 vs 16.0 nmol/l, P = 0.002). There was no difference in liver transaminases, lipids or IHCL between patients and controls (2.8 (1.3, 8.6) vs 5.0 (1.5, 12.7), P = 0.72), despite significantly higher visceral fat in GHD patients. Thirty-two percent of patients and 50% of controls had NAFLD (defined as IHCL > 5.6%), and the relationship between IHCL and BMI was the same in each group. GHR significantly reduced abdominal subcutaneous and visceral fat in all patients; however, GHR did not reduce liver fat. Conclusions: NAFLD is equally common in patients with GHD and matched controls. GHR is associated with a hierarchical reduction in fat deposition (fat loss: visceral > subcutaneous > liver). Further studies involving GHD patients with NAFLD are required to conclude the role of GHR in treating NAFLD.
AB - Objective: Non-alcoholic fatty liver disease (NAFLD) is reported to be more common in patients with GH deficiency (GHD) than in the general population. We aimed to determine: i) liver fat in patients with GHD compared with age and body mass index (BMI)-matched controls; and ii) effect of 6 months of GH replacement (GHR) on liver fat. Participants and methods: The study included 28 GHD patients and 24 controls. 12 patients were studied before and after 6 months of GHR. Anthropometry, liver enzymes and lipid profiles were measured, and body composition and intrahepatocellular lipid (IHCL) were determined by magnetic resonance imaging and spectroscopy. Results: Age and BMI (median (inter-quartile range)) of patients and controls were 52.6 (14) vs 52.6 (12) years (P = 0.9) and 27.8 (24.7, 34.7) vs 27.9 (25.1, 32.1) kg/m 2 (P = 0.9). IGF1 was lower in the patients (11.5 vs 16.0 nmol/l, P = 0.002). There was no difference in liver transaminases, lipids or IHCL between patients and controls (2.8 (1.3, 8.6) vs 5.0 (1.5, 12.7), P = 0.72), despite significantly higher visceral fat in GHD patients. Thirty-two percent of patients and 50% of controls had NAFLD (defined as IHCL > 5.6%), and the relationship between IHCL and BMI was the same in each group. GHR significantly reduced abdominal subcutaneous and visceral fat in all patients; however, GHR did not reduce liver fat. Conclusions: NAFLD is equally common in patients with GHD and matched controls. GHR is associated with a hierarchical reduction in fat deposition (fat loss: visceral > subcutaneous > liver). Further studies involving GHD patients with NAFLD are required to conclude the role of GHR in treating NAFLD.
UR - http://www.scopus.com/inward/record.url?scp=84862745289&partnerID=8YFLogxK
U2 - 10.1530/EJE-12-0002
DO - 10.1530/EJE-12-0002
M3 - Article
C2 - 22433286
AN - SCOPUS:84862745289
SN - 0804-4643
VL - 166
SP - 993
EP - 1002
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
IS - 6
ER -