Association between Alanine Aminotransferase and Growth Hormone: A Retrospective Cohort Study of Short Children and Adolescents.

Baolan Ji,Qianqian Zhao,Yanying Li,Hui Pan,Mei Zhang,Bo Ban,Yuntian Chu

doi:10.1155/2019/5939372

Abstract

Objective This study aimed to examine the relationship between serum alanine aminotransferase (ALT) and growth hormone (GH) in children and adolescents with short stature. Methods In this retrospective cohort study, 670 Chinese children and adolescents with short stature were included, and 253 of them received recombinant human GH (rhGH) therapy. Anthropometric and biochemical indicators were measured. GH peak levels were assessed after provocation tests with L-dopa and insulin. The subjects were divided into 3 groups according to the GH peak level. The association between the GH peak and ALT was analyzed. The change of ALT during rhGH therapy was assessed by a generalized additive mixed model. Results Serum ALT and incidence of ALT elevation were both decreased across the GH tertiles (P = 0.002, 0.012, respectively). A univariate analysis showed that the GH peak was negatively associated with ALT (β: -0.12; 95%CI: -0.22, -0.02; P = 0.023). Furthermore, multiple linear stepwise regression analysis demonstrated that the GH peak was independently related to ALT after adjusting for other confounding variables (β: -0.12; 95%CI: -0.24, -0.00; P = 0.042). Besides, mean values of the change in ALT from baseline displayed that, during the early stages of rhGH treatment, serum ALT level indicated a temporary upward trend, but it subsequently gradually decreased (β: -0.16; 95%CI: -0.23, -0.09; P < 0.001). ConclusionsGH secretion level was strongly negatively correlated with ALT in short children and adolescents. And rhGH therapy could reduce ALT level over time.

Highlights

Nonalcoholic fatty liver disease (NAFLD) encompasses a large spectrum of pathological changes that includes simple mild fatty liver to nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis in the absence of excessive alcohol consumption, which is a common, serious disease that affects the health of adults, children, and adolescents [1, 2]
The results displayed that the Body mass index (BMI), TG, low density lipoprotein-cholesterol (LDL-c), ALT and incidence of ALT elevation decreased across the tertiles
There were no obvious differences in age, SBP, DBP, total cholesterol (TC), high density lipoproteincholesterol (HDL-c), fasting plasma glucose (FPG), Cr and insulin-like growth factor-1 (IGF-1) in the Growth hormone (GH) tertiles

Summary

Introduction

Nonalcoholic fatty liver disease (NAFLD) encompasses a large spectrum of pathological changes that includes simple mild fatty liver to nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis in the absence of excessive alcohol consumption, which is a common, serious disease that affects the health of adults, children, and adolescents [1, 2]. Many clinical and epidemiological studies have revealed that NAFLD is associated with liverrelated morbidity and mortality and with an increased risk of developing cardiometabolic diseases [3]. As a common and useful indicator of hepatocyte injury, elevated serum alanine aminotransferase (ALT) level. Research has shown that serum ALT level is independently correlated with hepatic triglyceride content and might be more appropriate for use as a predictor of the degree of NAFLD than aspartate aminotransferase and gamma-glutamyl transferase [10]. Experimental research has indicated that the liver GH receptor or dysfunction of its downstream signaling pathways could elevate intracellular lipid accumulation and promote the development of NAFLD [11,12,13]. Clinical data have shown that GH deficiency (GHD) might be closely associated with the occurrence and progression of NAFLD [14,15,16,17]

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Results

Conclusion