The Effect of Growth Hormone Replacement on Liver Fat

Study Overview
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Brief Summary
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We will examine a cohort of growth hormone deficient adults starting growth hormone (GH) replacement. The purpose of this study is to determine whether GH replacement reduces the fat content of the liver. To compare the results we will include growth hormone deficient patients who do not start GH replacement as controls.

Detailed Description
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Adults with untreated growth hormone deficiency (GHD), a condition mostly due to pituitary disease, often show metabolic features similar to those described in the 'metabolic syndrome'. Growth hormone (GH) replacement has been shown to reverse many of these unfavorable changes, with a particular evident reduction of visceral fat. In recent years, a strong correlation between fat accumulation in the liver and features of the metabolic syndrome (particularly visceral fat) has been identified, and 'fatty liver' is now being referred as the hepatic feature of the 'metabolic syndrome'. The effect of GH replacement on liver fat, however, has never been systematically studied. We will assess 15 patients with GHD before and 6 months after starting GH replacement. We will also assess 15 control patients with GHD but who don't go on GH replacement for various reasons. Liver fat will be assessed using MR spectroscopy. Changes in liver fat will be correlated to changes in insulin sensitivity and changes in various inflammatory markers.

Official Title
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Growth Hormone Replacement in Adults With Growth Hormone Deficiency (GHD) - The Effect on Liver Fat.

Conditions
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Growth Hormone, Recombinant, Fatty Liver

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 20-70 years of age Growth hormone deficiency, with (cohort 1) or without (cohort 2) planned growth hormone (GH) replacement clinically stable Exclusion Criteria: known hepatic disease Acromegaly Diabetes mellitus growth hormone replacement within the last 12 months cushing's disease, if not cured for at least 12 months any contraindication to MR studies as set out in the MR safety questionnaire

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| 1<br>Patients with growth hormone (GH) deficiency starting GH replacement. | |
| 2<br>Patients with growth hormone (GH) deficiency not starting GH replacement. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intrahepatocellular Lipid (IHCL) Content | IHCL content determined by proton magnetic resonance spectroscopy (1H MRS). | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total Adipose Tissue | total adipose tissue assessed by MRI scan | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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growth hormone, growth hormone deficiency, liver fat, liver steatosis, growth hormone replacement