title: Nonalcoholic fatty liver disease in adult hypopituitary patients with GH deficiency and the impact of GH replacement therapy.
abstract: 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.
  
  
  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.
authors.affiliation: Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nishizawa
authors.forename: Genzo
authors.initials: G
authors.lastname: Iguchi
authors.forename: Ayumi
authors.initials: A
authors.lastname: Murawaki
authors.forename: Hidenori
authors.initials: H
authors.lastname: Fukuoka
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Hidesuke
authors.initials: H
authors.lastname: Kaji
authors.forename: Masaaki
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Kentaro
authors.initials: K
authors.lastname: Suda
authors.forename: Michiko
authors.initials: M
authors.lastname: Takahashi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Seo
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Yano
authors.forename: Riko
authors.initials: R
authors.lastname: Kitazawa
authors.forename: Sohei
authors.initials: S
authors.lastname: Kitazawa
authors.forename: Masafumi
authors.initials: M
authors.lastname: Koga
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Okimura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chihara
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takahashi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005234:Fatty Liver / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000172:deficiency / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D019382:Human Growth Hormone