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  • Author: Sohei Kitazawa x
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Hitoshi Nishizawa, Genzo Iguchi, Ayumi Murawaki, Hidenori Fukuoka, Yoshitake Hayashi, Hidesuke Kaji, Masaaki Yamamoto, Kentaro Suda, Michiko Takahashi, Yasushi Seo, Yoshihiko Yano, Riko Kitazawa, Sohei Kitazawa, Masafumi Koga, Yasuhiko Okimura, Kazuo Chihara and Yutaka Takahashi

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.

Patients and 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.