Effect of recombinant human growth hormone on liver fat content in young adults with nonalcoholic fatty liver disease.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is highly prevalent in young adults with obesity. Obesity is associated with relative growth hormone (GH) deficiency, and data from animal studies and from humans with pituitary GH deficiency suggest a role for GH deficiency in the pathogenesis of NAFLD. The effects of GH on NAFLD in those with obesity are unknown, however, prompting this pilot study to assess effects of GH administration on measures of NAFLD in young adults. Twenty-four men and women aged 18-29years with BMI≥30kg/m2 , hepatic fat fraction (HFF)≥5% on proton magnetic resonance spectroscopy (1 H-MRS) and insulin-like growth factor 1 (IGF-1) z-score≤0 were randomized to treatment with recombinant human GH (rhGH) versus no treatment for 24weeks. The primary endpoint was change in HFF. Compared to no treatment, the effect size of rhGH on absolute HFF over 24weeks was -3.3% (95% confidence interval: -7.8%, 1.2%; p=.14). At 24weeks, HFF<5% was achieved in 5 of 9 individuals receiving rhGH versus 1 of 9 individuals receiving no treatment (p=.04). rhGH did not significantly reduce ALT, AST or GGT. Serum IGF-1 increased as expected with rhGH treatment, and there were no changes in fasting lipids, C-reactive protein, fasting glucose or 2-h glucose following an oral glucose tolerance test. Data from this pilot study suggest that rhGH treatment in young adults with obesity and NAFLD may have benefits to reduce liver fat content, although larger studies are needed to confirm this effect.