Effect of growth hormone therapy on liver enzyme and other cardiometabolic risk factors in boys with obesity and nonalcoholic fatty liver disease

Abstract

Background Non-alcoholic fatty liver disease (NAFLD) has become the most common causes of liver disease in children and adolescents. Although several reports have confirmed the significant correlation between NAFLD and growth hormone (GH)-insulin-like growth factor 1(IGF-1) axis, no study further investigates whether or not recombinant human GH (rhGH) treatment can improve NAFLD in obese children. Methods This study was a randomized, open-label study comprising 44 boys with obesity and NAFLD (11.76 ± 1.67 year) to evaluate the effects of 6 months of rhGH administration for boys with obesity and NAFLD. The subjects were randomized divided into treatment group (subjects with recombinant human GH (rhGH)) and control group for 6 months. Results After 6 months, IGF-1 increased significantly during rhGH treatment, in comparison with the control group (582.45 ± 133.00 vs. 359.64 ± 129.00 ng/ml; p < 0.001). A significant reduction in serum alanine aminotransferase(ALT) (15.00 vs. 28.00 U/L; p = 0.001), aspartate aminotransferase(AST) (20.00 vs. 24.50U/L; p = 0.004), gamma glutamyl transferase(GGT) (14.50 vs. 28.50 U/L; p < 0.001) was observed in the GH-treated boys. In addition, the rhGH group showed a significant decrease in C reactive protein (CRP) (1.17 ± 0.76 vs. 2.26 ± 1.43 mg/L) and body mass index standard deviation scores (BMI SDS) (2.28 ± 0.80 vs. 2.71 ± 0.61) than the control group (p = 0.003, p = 0.049 respectively). GH treatment also reduced low density lipoprotein cholesterol (LDL-C) (2.19 ± 0.42 vs. 2.61 ± 0.66 mmol/L; p = 0.016) and increased high density lipoprotein cholesterol (HDL-C) (1.30 vs. 1.15 mmol/L; p = 0.005), and there were no changes in total cholesterol (TC), triglycerides (TG) and uric acid(UA) between the treatment group and the control group. Conclusion Our findings suggest that 6 months treatment with rhGH may be beneficial for liver enzyme and can improve obesity-related other cardiovascular and metabolic complications in boys with obesity and NAFLD.

Efficacy of Dapagliflozin Combined with Lifestyle Intervention in Obesity Control

“…LDL, TC, TG, and HDL are commonly used clinical blood lipid indicators, among which the increase of LDL is highly correlated with obesity [23,24]. Other studies have shown that TC and TG can be used as independent risk factors for metabolic diseases such as obesity and may be used as indicators for early prediction of obesity in middle-aged and elderly people [25,26]. New study shows that HDL levels are inversely related to the incidence of cardiovascular events caused by obesity [23,27].…”

Epidemiological characteristics and management of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis in China: A narrative review

“…56 The worrisome transition of diet structure and changes of lifestyle among Chinese citizens led to a rapid increase in the prevalence of obesity, particularly central obesity (a strong risk AST (20.0 vs. 24.5 U/L; P = 0.004), and GGT (14.5 vs. 28.5 U/L; P < 0.001) in treatment group than in control group. Lower BMI standard deviation scores in treatment group 82 (Continues)…”

Growth Hormone Signaling in Liver Diseases: Therapeutic Potentials and Controversies

“…IGF1 secretion, supplemental GH therapy may be beneficial for NAFLD patients by inducing IGF1 secretion. A randomized and open-label study comprising 44 boys with obesity and NAFLD demonstrated that 6-month treatment with recombinant human GH (rhGH, 0.033 mg/kg/day) significantly increased IGF1 levels and decreased serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma glutamyl transferase (GGT) compared to the control group [18]. Obesity and hepatic fat fraction (HFF) can be measured by body mass index (BMI) and 1 H-magnetic resonance spectroscopy ( 1 H-MRS), respectively [19].…”

“…A randomized and open-label study comprising 44 boys with obesity and NAFLD demonstrated that 6-month treatment with recombinant human GH (rhGH; 0.033 mg/kg/day) significantly increased IGF1 levels and decreased serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma glutamyl transferase (GGT) compared to the control group. 18 Obesity and hepatic fat fraction (HFF) can be measured by body mass index (BMI) and 1 H-magnetic resonance spectroscopy ( 1 H-MRS), respectively. 19 Twenty-four young adults, 18 to 29 years of age, BMI 30 kg/m 2 or greater, and HFF 5% or greater, were randomized to treatments with somatropin (human GH analog) for 24 weeks.…”