Table 2.
Studies Assessing the Relationship between NAFLD and Growth Hormone Deficiency
| Author | Year | Study design | Sample size | NAFLD diagnosis | Significant findings |
|---|---|---|---|---|---|
| Adams et al. | 2004 | Retrospective; single center | 21 | 10 based on liver biopsy and 11 based on imaging | NAFLD developed rapidly (on average 6.4 years) after the diagnosis of pituitary/hypothalamic dysfunction, and liver disease was severe; 60% of those biopsied had cirrhosis, and 14.3% (three) of the 21 received liver transplants or died. |
| Fukuda et al. | 2008 | Retrospective: single center | 42 | Ultrasound and elevated transaminases | Rate of NAFLD increased progressively after stopping GH therapy. The prevalence of NAFLD at 10 and 20 years after the cessation of GH was 22%/10% (M/F) and 33%/25% (M/F). |
| Hong et al. | 2011 | Cross-sectional; single center | 34 males with 40 controls | Ultrasound | The degree of fatty liver on abdominal ultrasonography correlated with the degree of GH deficiency even after adjusting for BMI. |
| Nishizawa et al. | 2012 | Retrospective; single center | 66 patients with 83 controls | Ultrasound; 16 had liver biopsy | GH replacement therapy significantly improved liver enzymes, histology, and levels of fibrotic markers in patients with NASH. |
| Gardner et al. | 2012 | Cross-sectional; single center | 28 patients with 24 controls | Magnetic resonance spectroscopy | NAFLD was equally prevalent in patients with GH deficiency and matched controls. GH replacement significantly decreased abdominal subcutaneous and visceral fat though it did not reduce liver fat. |
| Meienberg et al. | 2016 | Cross-sectional | 22 patients with 44 controls | Proton magnetic resonance spectroscopy | Liver fat content and the prevalence of NAFLD were similar in patients with GH deficiency and matched controls. GH-deficient patients had greater total and visceral fat mass. GH replacement therapy did not decrease hepatic fat fractions. |
| Kang et al. | 2021 | Cross-sectional | 76 patients with 74 controls | Transient elastography and MRI | 71% of patients with hypopituitarism had NAFLD, compared with 31% of controls. |
NAFLD, nonalcoholic fatty liver disease; GH, growth hormone; BMI, body mass index; M/F, males/females; MRI, magnetic resonance imaging; NASH, nonalcoholic steatohepatitis.