Effect of recombinant human growth hormone on liver fat content in young adults with nonalcoholic fatty liver disease

Abstract

BackgroundNonalcoholic fatty liver disease (NAFLD) is highly prevalent in young adults with obesity. Obesity is associated with relative growth hormone (GH) deficiency, and data from animal studies and from humans with pituitary GH deficiency suggest a role for GH deficiency in the pathogenesis of NAFLD. The effects of GH on NAFLD in those with obesity are unknown, however, prompting this pilot study to assess effects of GH administration on measures of NAFLD in young adults.MethodsTwenty‐four men and women aged 18–29 years with BMI ≥ 30 kg/m2, hepatic fat fraction (HFF) ≥ 5% on proton magnetic resonance spectroscopy (1H‐MRS) and insulin‐like growth factor 1 (IGF‐1) z‐score ≤ 0 were randomized to treatment with recombinant human GH (rhGH) versus no treatment for 24 weeks. The primary endpoint was change in HFF.ResultsCompared to no treatment, the effect size of rhGH on absolute HFF over 24 weeks was −3.3% (95% confidence interval: −7.8%, 1.2%; p = .14). At 24 weeks, HFF < 5% was achieved in 5 of 9 individuals receiving rhGH versus 1 of 9 individuals receiving no treatment (p = .04). rhGH did not significantly reduce ALT, AST or GGT. Serum IGF‐1 increased as expected with rhGH treatment, and there were no changes in fasting lipids, C‐reactive protein, fasting glucose or 2‐h glucose following an oral glucose tolerance test.ConclusionData from this pilot study suggest that rhGH treatment in young adults with obesity and NAFLD may have benefits to reduce liver fat content, although larger studies are needed to confirm this effect.

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

“…The results indicated that GH replacement therapy could improve chronic inflammatory state. In contrast to the results by prior study, Pan et al [ 14 ] reported no significant changes in CRP after 6 months of GH administration in young adults with obesity and NAFLD. One possible reason is that these studies reflect differences in study population and the dose of GH.…”

“…On the other hand, in adults with normal pituitary function, researchers also found that NAFLD patients had significant reductions in GH and IGF-1 levels, and the deficiencies in GH and IGF-1 contributed to the occurrence and development of NAFLD [ 9 , 10 ]. In addition, animal models also implicated that rhGH might improve NAFLD [ 11 – 13 ], and a clinical trial suggested that rhGH treatment might have benefits to reduce liver fat content in young adults with obesity and NAFLD [ 14 ]. However, to best of our knowledge, very few of studies used children as their experimental subjects, and there is no report focusing on the application of rhGH treatment to NAFLD with normal pituitary function in childhood obesity.…”

Ecotoxicological impacts of industrial effluents on irrigation water quality, animal health and the role of calcium alginate in effluents treatment

“…Kanwar and Kowdly ( 2014 ) attributed this to the presence of Fe, although it is an essential element in the body, in excess, it could break the liver barrier, leading to discharge of cell content to the bloodstream. Osuala et al ( 2014 ) added that Zn can also cause irritation in liver cells and decrease intracellular liver enzymes. Moreover, rough measures of protein status reflect major functional changes in the liver.…”

“…The liver is the major organ for conjugating and detoxifying any potential toxic substances. It is also essential for intermediary metabolism and the synthesis of several important compounds (Osuala et al, 2014 ). The concentration of liver enzymes in the blood is an important diagnostic biomarker for assessing liver damage (Talkhan et al, 2016 ).…”

Nuclear hormone and peptide hormone therapeutics for NAFLD and NASH

“…An analysis of biopsied livers demonstrated that tesamorelin increased transcriptional markers of oxidative phosphorylation and decreased gene sets linked to inflammation [ 109 ]. Whether these benefits on hepatic fat content translate to non-HIV patients remains to be proven, but recent clinical results with GH in obese NAFL patients [ 110 ] lend credence to targeting this biological pathway for NASH benefits. The recently announced phase 3 trial of tesamorelin in general NASH patients will hopefully provide definitive proof.…”