Article

Nonalcoholic fatty liver in patients with Laron syndrome and GH gene deletion - preliminary report.

Endocrinology and Diabetes Research Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
Growth Hormone & IGF Research (impact factor: 2.16). 11/2008; 18(5):434-8. DOI:10.1016/j.ghir.2008.03.003 pp.434-8
Source: PubMed

ABSTRACT There is little information on the relationship between growth hormone/insulin-like growth factor-I (GH/IGF-I) deficiency or IGF-I treatment on nonalcoholic fatty liver disease (NAFLD) a disorder linked to obesity and insulin resistance.
To find out whether the markedly obese patients with Laron syndrome (LS) and GH gene deletion have fatty livers.
We studied 11 untreated adult patients with LS (5M, 6F), five girls with LS treated by IGF-I and five adult patients with GH gene deletion (3M, 3F), four previously treated by hGH in childhood.
Fatty liver was quantitatively evaluated by ultrasonography using a phase array US system (HITACHI 6500, Japan). Body adiposity was determined by DEXA, and insulin resistance was estimated by HOMA-IR using the fasting serum glucose and insulin values.
Six out of 11 adult patients with LS, two out of the five IGF-I treated girls with LS and three out of five adult hGH gene deletion patients were found to have NAFLD (nonalcoholic fatty liver disease).
NAFLD is a frequent complication in untreated and treated congenital IGF-I deficiency. No correlation between NAFLD and age, sex, degree of obesity, blood lipids, or degree of insulin resistance was observed.

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    Article: The decreased growth hormone response to growth hormone releasing hormone in obesity is associated to cardiometabolic risk factors.
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    ABSTRACT: The aim of the present study was to evaluate the relationship between GHRH-induced GH secretion in obese premenopausal women and cardiovascular risk markers or insulin resistance. Premenopausal obese women, aged 35-52 years, were studied. GH secretion, IGF-I, serum cardiovascular risk markers, insulin, leptin, mid-waist and hip circumference, total body fat, and truncal fat were measured. Subjects were classified as meeting the criteria for GH deficiency (GHD) when peak GH after stimulation with GHRH was <or=3 microg/L. Mean total and LDL cholesterol, fasting insulin, and HOMA-IR were all higher, in subjects who would have been classified as GH-deficient compared with GH-sufficient. Peak GH secretion after stimulation was inversely associated with fasting insulin (R = -0.650, P = .012), HOMA-IR (R = -0.846, P = .001), total cholesterol (R = -0.532, P = .034), and LDL cholesterol (R = -0.692, P = .006) and positively associated with HDL cholesterol (R = 0.561, P = .037). These data strongly suggest a role for insulin resistance in the decreased GH secretion of obesity and that the blunted GH secretion of central obesity could be the pituitary expression of the metabolic syndrome.
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Keywords

11 adult patients
 
11 untreated adult patients
 
adult hGH gene deletion patients
 
adult patients
 
blood lipids
 
congenital IGF-I deficiency
 
fasting serum glucose
 
Fatty liver
 
five IGF-I
 
frequent complication
 
GH gene deletion
 
GH/IGF-I
 
growth hormone/insulin-like growth factor-I
 
hGH
 
insulin resistance
 
insulin values
 
Laron syndrome
 
markedly obese patients
 
nonalcoholic fatty liver disease
 
phase array