The First department of Internal Medicine, Graduate school of Biomedical science, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan,
Hepatol Int. 2007 Jun;1(2):287-94. doi: 10.1007/s12072-007-9007-4. Epub 2007 Jun 1.
Pituitary dysfunction including growth hormone (GH) deficiency may be associated with non-alcoholic fatty liver disease (NAFLD). Since the relationships among GH, IGF-1, IGFBP-3, and development of NAFLD without hypopituitarism are unclear, we examined the role of these hormones in the development of NAFLD based on clinical, laboratory and liver histology data.
A total of 55 consecutive patients (20 males and 35 females) with NAFLD.
Aspartate amino transferase (AST), AST/ALT, platelet count and IGF-1, levels were significantly associated with differences in fibrosis, since these variables differed between stage 0-1 and stage 2-3 NAFLD. In multivariate analysis, platelet count (P = 0.0223, relative risk (RR), 5.899; 95% confidence interval (CI), 1.288-27.017), and IGF-1 (P = 0.0363, RR, 4.568; 95% CI, 1.101-18.945) showed significant associations with stage 2-3 NAFLD. Additionally, hyaluronic acid levels had a negative relationship with IGF-1 and the IGF-1/IGFBP-3 ratio. There was no relationship of fibrosis with GH level, but decreased GH (P = 0.0414, RR, 0.199; 95% CI, 0.042-0.989) was significantly associated with steatosis of stage 2-3. Low GH/IGF-1 and GH/IGFBP-3 ratios were found in advanced steatosis.
GH, IGF-1 and IGFBP-3 are associated with hepatic fibrosis and steatosis in NAFLD. Low levels of IGF-1 might be associated with fibrosis while low level of GH with hepatic steatosis.
包括生长激素(GH)缺乏在内的垂体功能障碍可能与非酒精性脂肪性肝病(NAFLD)有关。由于 GH、IGF-1、IGFBP-3 与无垂体功能减退的 NAFLD 之间的关系尚不清楚,我们根据临床、实验室和肝脏组织学数据来研究这些激素在 NAFLD 发展中的作用。
共纳入 55 例连续的 NAFLD 患者(20 名男性和 35 名女性)。
天冬氨酸氨基转移酶(AST)、AST/ALT、血小板计数和 IGF-1 水平与纤维化程度差异显著相关,因为这些变量在 NAFLD 0-1 期和 2-3 期之间有所不同。在多变量分析中,血小板计数(P = 0.0223,相对风险(RR),5.899;95%置信区间(CI),1.288-27.017)和 IGF-1(P = 0.0363,RR,4.568;95%CI,1.101-18.945)与 2-3 期 NAFLD 显著相关。此外,透明质酸水平与 IGF-1 和 IGF-1/IGFBP-3 比值呈负相关。纤维化与 GH 水平无关系,但 GH 降低(P = 0.0414,RR,0.199;95%CI,0.042-0.989)与 2-3 期肝脂肪变性显著相关。在晚期脂肪变性中发现了低 GH/IGF-1 和 GH/IGFBP-3 比值。
GH、IGF-1 和 IGFBP-3 与 NAFLD 中的肝纤维化和脂肪变性有关。IGF-1 水平低可能与纤维化有关,而 GH 水平低可能与肝脂肪变性有关。