Liver fat in adults with GH deficiency: comparison to matched controls and the effect of GH replacement

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Abstract

Context

Existing data regarding the association between growth hormone deficiency (GHD) and liver fat content are conflicting.

Objective

We aimed (i) to assess intrahepatocellular lipid (IHCL) content in hypopituitary adults with GHD compared to matched controls and (ii) to evaluate the effect of growth hormone (GH) replacement on IHCL content.

Design

Cross-sectional comparison and controlled intervention study.

Patients, Participants

Cross-sectional comparison: Twenty-two hypopituitary adults with GHD and 44 healthy controls matched for age, BMI, gender and ethnicity. Intervention study: nine GHD patients starting GH replacement (GH Rx group) and nine GHD patients not starting replacement therapy (non-GH Rx group).

Intervention

Intervention study: GH replacement for 6 months in the GH Rx group, dosage was titrated to achieve normal IGF-1 levels.

Main Outcome Measures

HCL content determined by proton magnetic resonance spectroscopy (1H MRS).

Results

Cross-sectional Comparison: There was no difference in IHCL content between GHD patients and healthy controls (1·89% (0·30, 4·03) vs 1·14% (0·22, 2·32); P = 0·2), and the prevalence of patients with hepatic steatosis (IHCL of ≥ 5·56%) was similar in the two groups (22·7% vs 15·9%; chi-square probability = 0·4). Intervention study: The change in IHCL content over 6 months did not differ between the GH Rx group and the non-GH Rx group (−0·63 ± 4·53% vs + 0·11 ± 1·46%; P = 0·6).

Conclusions

In our study, liver fat content and the prevalence of hepatic steatosis did not differ between hypopituitary adults with GHD and matched controls. In GHD patients, GH replacement had no effect on liver fat content.

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