title: Nonalcoholic fatty liver disease is associated with increased GHBP and reduced GH/IGF-I levels.
abstract: BACKGROUND
  Nonalcoholic fatty liver disease (NAFLD) has been described in adult GH deficiency syndrome. Furthermore, chronic liver disease can be associated with significant changes in levels of IGF-I, GH-binding protein (GHBP), IGF-binding proteins (IGFBPs) and acid-labile subunit (ALS). However, the effect of liver steatosis on the GHBP production has not been investigated yet.
  
  
  OBJECTIVE
  To explore whether GH secretion and/or levels of IGF-I, IGFBP-3, ALS and GHBP could be altered in obese patients in relation to the presence of liver steatosis.
  
  
  METHODS
  A total of 115 obese patients (BMI > 30) were enrolled in the protocol (65 patients with liver steatosis and 50 age- and BMI-matched controls). In all patients, the following parameters were studied: serum levels of glucose, insulin, the HOMA index, IGF-I, GHBP, IGFBP-3, ALS and GH after GHRH and arginine stimulation test.
  
  
  RESULTS
  As expected, patients with NAFLD had blood glucose, insulin, HOMA-R significantly higher than controls, indicating a more severe insulin-resistance state in NAFLD. Furthermore, patients with NAFLD had higher levels of GHBP and IGFBP-3 and lower GH peak and IGF-I levels as compared to controls. No difference was found in ALS levels between the groups. In a multivariate analysis, GHBP was positively associated with hepatic steatosis while IGF-1 was negatively associated with hepatic steatosis.
  
  
  CONCLUSIONS
  This study demonstrates that in patients with NAFLD, the GHBP levels are increased, and that the GH/IGF-I axis is significantly altered probably leading to reduced IGF-I bioavailability at tissue level.
authors.affiliation: Division of Endocrinology, Catholic University, School of Medicine, Rome, Italy. alefusc@yahoo.it
authors.forename: Alessandra
authors.initials: A
authors.lastname: Fusco
authors.forename: Luca
authors.initials: L
authors.lastname: Miele
authors.forename: Annalisa
authors.initials: A
authors.lastname: D'Uonnolo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Forgione
authors.forename: Laura
authors.initials: L
authors.lastname: Riccardi
authors.forename: Consuelo
authors.initials: C
authors.lastname: Cefalo
authors.forename: Angela
authors.initials: A
authors.lastname: Barini
authors.forename: Antonio
authors.initials: A
authors.lastname: Bianchi
authors.forename: Antonella
authors.initials: A
authors.lastname: Giampietro
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Cimino
authors.forename: Raffaele
authors.initials: R
authors.lastname: Landolfi
authors.forename: Antonio
authors.initials: A
authors.lastname: Grieco
authors.forename: Laura
authors.initials: L
authors.lastname: De Marinis
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002352:Carrier Proteins / Q000097:blood*; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000097:blood*; D005260:Female; D006023:Glycoproteins / Q000097:blood; D013006:Growth Hormone / Q000097:blood*; D006801:Humans; D018969:Insulin-Like Growth Factor Binding Proteins / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D009765:Obesity / Q000097:blood
chemical_list: D001786:Blood Glucose; D002352:Carrier Proteins; D006023:Glycoproteins; D018969:Insulin-Like Growth Factor Binding Proteins; C075944:insulin-like growth factor binding protein, acid labile subunit; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; C051815:somatotropin-binding protein