Key result
Adult growth hormone deficiency is associated with a 29% to 77% prevalence of nonalcoholic fatty liver disease, though the efficacy of growth hormone replacement remains controversial.
Why the study?
Adult growth hormone deficiency often remains underdiagnosed or untreated, and its association with NAFLD and progression to NASH is overlooked, with existing studies showing controversial results.
Does growth hormone replacement therapy improve NAFLD in patients with adult growth hormone deficiency?
Does growth hormone replacement therapy improve NAFLD in patients with adult growth hormone deficiency?
Adult growth hormone deficiency is an underrecognized risk factor for the rapid development and progression of NAFLD to NASH, highlighting the need for multidisciplinary screening and potential GH replacement.
Highlights high NAFLD burden in adult GHD; leaves open whether GH replacement improves liver outcomes.
Growth hormone and its mediator insulin-like growth factor-1 exert their effect on different organs and control various physiologic metabolic processes. Adult growth hormone deficiency (AGHD) presents with one or more components of metabolic syndrome and can be associated with nonalcoholic fatty liver disease (NAFLD). AGHD is present in spectrum of hypothalamic/pituitary disorders as well as cranial radiation of brain tumors and often remains underdiagnosed or untreated due to its nonspecific symptoms, relatively difficult diagnosis in some clinical scenarios, and various barriers to treatment. NAFLD usually develops soon after diagnosis of AGHD and might progress rapidly to nonalcoholic steatohepatitis (NASH) with advanced fibrosis, eventually requiring liver transplantation. A timely initiation of growth hormone replacement therapy might be important, although studies so far have demonstrated controversial results on NAFLD, primarily due to small sample size and different diagnostic methods of NAFLD. Increased awareness of the association between AGHD and NAFLD would facilitate early diagnosis of NAFLD and NASH if present. Therefore, a multidisciplinary approach involving hepatology and endocrinology should become a standard of care for these patients.
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Doycheva et al. (2022) conducted a review in Adult growth hormone deficiency (AGHD) and nonalcoholic fatty liver disease (NAFLD). Growth hormone replacement therapy was evaluated. Adult growth hormone deficiency is associated with a 29% to 77% prevalence of nonalcoholic fatty liver disease, though the efficacy of growth hormone replacement remains controversial.
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