Growth hormone reverses nonalcoholic steatohepatitis in a patient with adult growth hormone deficiency.
OBJECTIVE
Nonalcoholic steatohepatitis (NASH) is an emerging progressive hepatic disease and demonstrates steatosis, inflammation, and fibrosis. Insulin resistance is a common feature in the development of NASH. Molecular pathogenesis of NASH consists of 2 steps: triglyceride accumulation in hepatocytes with insulin resistance and an enhanced oxidative stress caused by reactive oxygen species. Interestingly, NASH demonstrates a striking similarity to the pathologic conditions observed in adult growth hormone deficiency (AGHD). AGHD is characterized by decreased lean body mass, increased visceral adiposity, abnormal lipid profile, and insulin resistance. Moreover, liver dysfunctions with hyperlipidemia and nonalcoholic fatty liver disease (NAFLD) are frequently observed in patients with AGHD, and it is accompanied by metabolic syndrome.


METHODS
We studied a case diagnosed as NASH with hyperlipidemia in AGHD. The effect of GH-replacement therapy on the patient was analyzed.


RESULTS
Six months of GH-replacement therapy in the patient drastically ameliorated NASH and the abnormal lipid profile concomitant with a marked reduction in oxidative stress.


CONCLUSIONS
These results suggest that GH plays an essential role in the metabolic and redox regulation in the liver.
Takahashi
Yutaka
Y
Division of Endocrinology/Metabolism, Neurology, and Hematology/Oncology, Department of Clinical Molecular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. takahash@med.kobe-u.ac.jp
Iida
Keiji
K
Takahashi
Kentaro
K
Yoshioka
Shiro
S
Fukuoka
Hidenori
H
Takeno
Ryoko
R
Imanaka
Mari
M
Nishizawa
Hitoshi
H
Takahashi
Michiko
M
Seo
Yasushi
Y
Hayashi
Yoshitake
Y
Kondo
Takuma
T
Okimura
Yasuhiko
Y
Kaji
Hidesuke
H
Kitazawa
Riko
R
Kitazawa
Sohei
S
Chihara
Kazuo
K
D000328:Adult; D005234:Fatty Liver / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D006505:Hepatitis / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D019382:Human Growth Hormone / Q000008:administration & dosage* / Q000172:deficiency; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D007018:Hypopituitarism / Q000097:blood / Q000150:complications*; D007279:Injections, Subcutaneous; D008099:Liver / Q000187:drug effects / Q000473:pathology; D008297:Male; D011994:Recombinant Proteins / Q000008:administration & dosage; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D011994:Recombinant Proteins; D019382:Human Growth Hormone