Metabolic Parameters and Nonalcoholic Fatty Liver Disease in Hypopituitary Men

Hong, Jing; Kim, J. Y.; Kim, Y.-E.; Lee, Mi Kyung

doi:10.1055/s-0030-1265217

Cited by 49 publications

(59 citation statements)

References 19 publications

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“…Ichikawa et al [8] reported that in patients with adult onset anterior lobe pituitary hormone deficiency (with or without GH deficiency), NAFLD was more frequently observed in patients with GH deficiency. Decreased GH levels were also associated with the severity of hepatic steatosis in other studies [3], [9]. Furthermore, hypothalamic/pituitary dysfunction may be accompanied by progressive NAFLD and excessive weight gain, impaired glucose tolerance, and dyslipidemia [10].…”

Section: Introductionmentioning

confidence: 68%

“…Low GH secretion from the pituitary is associated with increased visceral body fat and other features of the metabolic syndrome. For example, in a previous study, patients with GH deficiency had significance higher body mass index (BMI) and waist circumference, and elevated serum total cholesterol, low-density lipoprotein cholesterol and triglycerides than the controls [3]. Adult patients with GH deficiency also had a higher prevalence of the metabolic syndrome than the controls [4], [5].…”

Section: Introductionmentioning

confidence: 93%

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Association between Serum Growth Hormone Levels and Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study

et al. 2012

PLoS ONE

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Growth hormone (GH) is an important regulator of metabolism and body composition. GH deficiency is associated with increased visceral body fat and other features of the metabolic syndrome. Here we performed a cross-sectional study to explore the association of GH levels with nonalcoholic fatty liver disease (NAFLD), which is considered to be the hepatic manifestation of the metabolic syndrome. A total of 1,667 subjects were diagnosed as NAFLD according the diagnostic criteria, and 5,479 subjects were defined as the controls. The subjects with NAFLD had significantly lower levels of serum GH than the controls. Those with low GH levels had a higher prevalence of NAFLD and the metabolic syndrome. A stepwise logistic regression analysis showed that GH levels were significantly associated with the risk factor for NAFLD (OR = 0.651, 95%CI = 0.574–0.738, P<0.001). Our results showed a significant association between lower serum GH levels and NAFLD.

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Section: Introductionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 93%

Association between Serum Growth Hormone Levels and Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study

et al. 2012

PLoS ONE

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“…In another case of adult hypopituitary patients with GHD accompanied by nonalcoholic steatohepatitis (NASH) and hyperlipidemia, we reported that GH replacement therapy drastically reversed NASH (6). Moreover, the severity of fatty liver was shown to be related to hypopituitary patients' GH levels (7). Interestingly, in the non-GH-deficient population, GH, insulin-like growth factor 1 (IGF1), and IGF-binding protein 3 were associated with hepatic fibrosis and steatosis in NAFLD (8), suggesting that the GH-IGF1 axis may play an important role in the liver in the physiological condition.…”

Section: Introductionmentioning

confidence: 92%

Nonalcoholic fatty liver disease in adult hypopituitary patients with GH deficiency and the impact of GH replacement therapy

Nishizawa

Iguchi

Murawaki

et al. 2012

European Journal of Endocrinology

142

132

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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.

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“…[49][50][51][52][53][54][55][56][57][58][59][60] In addition to poor QoL, both GHD and hypogonadism can contribute to decreased lean body mass, increased fat mass (in particular, visceral fat), and poor exercise capacity that further contribute to poor QoL, obesity, and MetS, increasing cardiovascular disease (CVD) risk. 51,54,57,[61][62][63][64][65][66][67][68][69][70] Studies have shown that MetS is associated with, and predicts the development of, low serum testosterone levels in men. 62,64,65,71 Five of 6 subjects with hypogonadism had MetS and obesity.…”

Section: Previous Studies On Postconcussive Hypopituitarismmentioning

confidence: 99%

Prevalence of Pituitary Hormone Dysfunction, Metabolic Syndrome, and Impaired Quality of Life in Retired Professional Football Players: A Prospective Study

Kelly

Chaloner

Evans

et al. 2014

Journal of Neurotrauma

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Hypopituitarism is common after moderate and severe traumatic brain injury (TBI). Herein, we address the association between mild TBI (mTBI) and pituitary and metabolic function in retired football players. Retirees 30-65 years of age, with one or more years of National Football League (NFL) play and poor quality of life (QoL) based on Short Form 36 (SF-36) Mental Component Score (MCS) were prospectively enrolled. Pituitary hormonal and metabolic syndrome (MetS) testing was performed. Using a glucagon stimulation test, growth hormone deficiency (GHD) was defined with a standard cut point of 3 ng/mL and with a more stringent body mass index (BMI)-adjusted cut point. Subjects with and without hormonal deficiency (HD) were compared in terms of QoL, International Index of Erectile Function (IIEF) scores, metabolic parameters, and football career data. Of 74 subjects, 6 were excluded because of significant non-football-related TBIs. Of the remaining 68 subjects (mean age, 47.3 -10.2 years; median NFL years, 5; median NFL concussions, 3; mean BMI, 33.8 -6.0), 28 (41.2%) were GHD using a peak GH cutoff of < 3 ng/mL. However, with a BMI-adjusted definition of GHD, 13 of 68 (19.1%) were GHD. Using this BMI-adjusted definition, overall HD was found in 16 (23.5%) subjects: 10 (14.7%) with isolated GHD; 3 (4.4%) with isolated hypogonadism; and 3 (4.4%) with both GHD and hypogonadism. Subjects with HD had lower mean scores on the IIEF survey ( p = 0.016) and trended toward lower scores on the SF-36 MCS ( p = 0.113). MetS was present in 50% of subjects, including 5 of 6 (83%) with hypogonadism, and 29 of 62 (46.8%) without hypogonadism ( p = 0.087). Age, BMI, median years in NFL, games played, number of concussions, and acknowledged use of performance-enhancing steroids were similar between HD and non-HD groups. In summary, in this cohort of retired NFL players with poor QoL, 23.5% had HD, including 19% with GHD (using a BMI-adjusted definition), 9% with hypogonadism, and 50% had MetS. Although the cause of HD is unclear, these results suggest that GHD and hypogonadism may contribute to poor QoL, erectile dysfunction, and MetS in this population. Further study of pituitary function is warranted in athletes sustaining repetitive mTBI.

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Metabolic Parameters and Nonalcoholic Fatty Liver Disease in Hypopituitary Men

Cited by 49 publications

References 19 publications

Association between Serum Growth Hormone Levels and Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study

Association between Serum Growth Hormone Levels and Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study

Nonalcoholic fatty liver disease in adult hypopituitary patients with GH deficiency and the impact of GH replacement therapy

Prevalence of Pituitary Hormone Dysfunction, Metabolic Syndrome, and Impaired Quality of Life in Retired Professional Football Players: A Prospective Study

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