Efficacy Analysis Of Recombinant Human Growth Hormone Replacement Therapy On Adult Growth Hormone Deficiency With Nonalcoholic Fatty Liver

Objective:Analyzing the therapeutic effect of recombinant human growth hormone on adult growth hormone deficiency with nonalcoholic fatty liver.Methods:This study included 25 adult patients with growth hormone deficiency and nonalcoholic fatty liver,analyzed the causes,and compared the changes of body mass index(BMI),lean body mass percentage(LBM%),waist circumference(WC),body fat ratio(BFR),insulin-like growth factor-1(IGF-1),liver function and blood lipid before and after growth hormone treatment.SPSS26.0(IBM,Armonk,New York,USA)was used for data analysis of this experiment.For measurement data that obey normal or approximate normal distribution,mean value ± standard deviation(X±S)was used for description,and paired sample t-test(intra group comparison)was used for difference analysis;P<0.05 was statistically significant.This study was a bilateral test.Results:1.Among the 25 patients included in this study,the causes of hypopituitarism were pituitary adenoma in 7 cases(28%),craniopharyngioma in 7 cases(28%),germ cell tumor in 5 cases(20%),hypoplastic pituitary in 3 cases(12%),Xihan syndrome in 1 case(4%),and traumatic brain injury in 2 cases(8%).2.Changes of blood lipid profile before and after growth hormone treatment:blood lipid before treatment: Compared with the results before and after treatment,LDL-C and TC decreased significantly,while HDL-C increased significantly,and the difference was statistically significant(P < 0.05).There was no significant change in TG before and after treatment(P > 0.05),and the difference was not statistically significant.3.Changes of liver function enzymes before and after growth hormone treatment: liver function before treatment: compared with the results before and after the treatment,AST,ALT and GGT all decreased,and the difference was statistically significant(p <0.05).4.Body composition before and after growth hormone treatment: After treatment,BMI,WC,BFR were significantly decreased and LBM was significantly increased(P < 0.05).5.Pathological results of patients with liver biopsy: Among 25 cases of adult growth hormone deficiency with nonalcoholic fatty liver disease,10 patients had liver biopsy before using growth hormone to determine the status of liver disease,including3 cases of simple fatty liver(SFL)(30%),5 cases of nonalcoholic steatohepatitis(NASH)(50%),and 2 cases of nonalcoholic fatty liver cirrhosis(NAFLC)(20%).Conclusions:1.Among the patients with AGHD and NAFLD,the most common cause was pituitary adenoma after radiotherapy(28%).Non alcoholic steatohepatitis,even cirrhosis,has occurred in some patients with liver biopsy,indicating that the liver disease progresses rapidly.2.Most patients with AGHD and NAFLD have abnormal lipid metabolism: the main manifestation is the increase of TC,TG,LDL-c,and the decrease of HDL-c.3.GH treatment can improve the blood lipid profile of AGHD patients with NAFLD: TC,LDL-C decrease,HDL-C increase.4.GH treatment can improve the body composition of AGHD patients with NAFLD: reduce the patient’s weight,reduce body mass index and body fat rate,reduce waist circumference,and increase the percentage of lean body weight.5.GH treatment can improve the liver function of AGHD patients with NAFLD and delay the progression of fatty liver.