Growth hormone reverses nonalcoholic steatohepatitis in a patient with adult growth hormone deficiency
Growth hormone reverses nonalcoholic steatohepatitis in a patient with adult growth hormone deficiency
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DOI：
10.1053/j.gastro.2006.12.024
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发表时间：
2007-03-01
期刊：
影响因子：
29.4
通讯作者：
Chihara, Kazuo
中科院分区：
文献类型：
--
作者：
Takahashi, Yutaka;Iida, Keiji;Chihara, Kazuo
背景和目标：非酒精性脂肪性肝炎（NASH）是一种新出现的进行性肝病，表现为脂肪变性、炎症和纤维化。胰岛素抵抗是NASH发展中的常见特征。NASH的分子发病机制包括两个步骤：胰岛素抵抗的肝细胞中甘油三酯积累和活性氧引起的氧化应激增强。有趣的是，NASH表现出与在成人生长激素缺乏症（AGHD）中观察到的病理状况惊人的相似性。AGHD的特征是瘦体重减少、内脏脂肪增多、血脂异常和胰岛素抵抗。此外，在AGHD患者中经常观察到伴有高脂血症和非酒精性脂肪性肝病（NAFLD）的肝功能障碍，并伴有代谢综合征。方法：对1例非酒精性脂肪性肝炎合并高脂血症的AGHD患者进行分析.分析GH替代治疗对患者的影响。结果如下：6个月的GH替代治疗的患者大大改善了NASH和血脂异常伴随着氧化应激显着减少。结论：GH在肝脏代谢和氧化还原调节中起重要作用。
Background & Aims: Nonalcoholic steatohepatitis (NASH) is an emerging progressive hepatic disease and demonstrates steatosis, inflammation, and fibrosis. Insulin resistance is a common feature in the development of NASH. Molecular pathogenesis of NASH consists of 2 steps: triglyceride accumulation in hepatocytes with insulin resistance and an enhanced oxidative stress caused by reactive oxygen species. Interestingly, NASH demonstrates a striking similarity to the pathologic conditions observed in adult growth hormone deficiency (AGHD). AGHD is characterized by decreased lean body mass, increased visceral adiposity, abnormal lipid profile, and insulin resistance. Moreover, liver dysfunctions with hyperlipidemia and nonalcoholic fatty liver disease (NAFLD) are frequently observed in patients with AGHD, and it is accompanied by metabolic syndrome. Methods: We studied a case diagnosed as NASH with hyperlipidemia in AGHD. The effect of GH-replacement therapy on the patient was analyzed. Results: Six months of GH-replacement therapy in the patient drastically ameliorated NASH and the abnormal lipid profile concomitant with a marked reduction in oxidative stress. Conclusions: These results suggest that GH plays an essential role in the metabolic and redox regulation in the liver.