Nonalcoholic fatty liver disease in adult hypopituitary patients with GH deficiency and the impact of GH replacement therapy

被引：143

作者：

Nishizawa, Hitoshi ^{[1
]}

Iguchi, Genzo ^{[1
]}

Murawaki, Ayumi ^{[1
]}

Fukuoka, Hidenori ^{[1
]}

Hayashi, Yoshitake ^{[2
]}

Kaji, Hidesuke ^{[3
]}

Yamamoto, Masaaki ^{[1
]}

Suda, Kentaro ^{[1
]}

Takahashi, Michiko ^{[1
]}

Seo, Yasushi ^{[4
]}

Yano, Yoshihiko ^{[4
]}

Kitazawa, Riko ^{[5
]}

Kitazawa, Sohei ^{[5
]}

Koga, Masafumi ^{[6
]}

Okimura, Yasuhiko ^{[7
]}

Chihara, Kazuo ^{[8
]}

Takahashi, Yutaka ^{[1
]}

机构：

[1] Kobe Univ, Dept Internal Med, Div Diabet & Endocrinol, Grad Sch Med,Chuo Ku, Kobe, Hyogo 6500017, Japan

[2] Kobe Univ, Div Mol Med & Med Genet, Dept Pathol, Grad Sch Med, Kobe, Hyogo 6500017, Japan

[3] Univ Hyogo, Div Physiol Metab, Akashi, Hyogo, Japan

[4] Kobe Univ, Dept Gastroenterol, Grad Sch Med, Kobe, Hyogo 6500017, Japan

[5] Ehime Univ, Grad Sch Med, Div Mol Pathol, Matsuyama, Ehime 790, Japan

[6] Kinki Cent Hosp, Dept Internal Med, Itami, Hyogo, Japan

[7] Kobe Womens Univ, Dept Nutr & Food Sci, Kobe, Hyogo, Japan

[8] Hyogo Prefectural Kakogawa Med Ctr, Kakogawa, Hyogo, Japan

来源：

EUROPEAN JOURNAL OF ENDOCRINOLOGY | 2012年 / 167卷 / 01期

关键词：

GROWTH-HORMONE DEFICIENCY; HEPATIC STEATOSIS; STEATOHEPATITIS; JAPAN; DIAGNOSIS; GLUCOSE; MASS; MEN;

D O I：

10.1530/EJE-12-0252

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Liver dysfunction in adult hypopituitary patients with GH deficiency (GHD) has been reported and an increased prevalence of nonalcoholic fatty liver disease (NAFLD) has been suggested. Objective: The objective of the present study was to elucidate the pathophysiology of the liver in adult hypopituitary patients with GHD. Patients and methods: We recruited 69 consecutive Japanese adult hypopituitary patients with GHD and examined the prevalence of NAFLD by ultrasonography and nonalcoholic steatohepatitis (NASH) by liver biopsy. Patients had been given routine replacement therapy except for GH. We compared these patients with healthy age-, gender-, and BMI-matched controls. We further analyzed the effect of GH replacement therapy on liver function, inflammation and fibrotic markers, and histological changes. Results: The prevalence of NAFLD in hypopituitary patients with GHD was significantly higher than in controls (77 vs 12%, P<0.001). Of 16 patients assessed by liver biopsy, 14 (21%) patients were diagnosed with NASH. GH replacement therapy significantly reduced serum liver enzyme concentrations in the patients and improved the histological changes in the liver concomitant with reduction in fibrotic marker concentrations in patients with NASH. Conclusions: Adult hypopituitary patients with GHD demonstrated a high NAFLD prevalence. The effect of GH replacement therapy suggests that the NAFLD is predominantly attributable to GHD.

引用

页码：67 / 74

页数：8