1566-P: Growth Hormone Replacement Treatment Improves Nonalcoholic Fatty Liver Disease in Patients with Pituitary Stalk Interruption Syndrome—A Randomized, Single-Blind, Placebo-Controlled Prospective Cohort Study

Background: Non-alcoholic fatty liver disease (NAFLD) commonly coexists as a comorbidity among patients with pituitary stalk interruption syndrome (PSIS) with growth hormone deficiency (GHD). This study aimed to investigate the impact of GH replacement therapy on liver fat content and metabolic parameters in PSIS patients with GHD and NAFLD.

Methods: In this randomized, single-blind, placebo-controlled prospective trial, 14 adults with PSIS, who have GHD and LFC ≥ 6%, aged 20 to 50 years without diabetes, were randomized to weekly subcutaneous GH (n=8) or placebo (n=6), targeting insulin-like growth factor 1 to normal quartile. The primary endpoint was LFC assessed before and after 32-week treatment using magnetic resonance imaging-derived proton density fat fraction.

Results: The GH group had significantly greater reduction in LFC compared to placebo group (mean ± SD: -11.48±9.26 % vs -3.12±4.12, P=0.046). Additionally, GH group showed a more substantial median decrease in gamma-glutamyl transferase levels than placebo group [-5.50, interquartile range(IQR) -42.75 to -2.25 vs 5.00, IQR -14.75 to 25.00 U/L, P 0.029]. No significant differences were observed in the changes of aspartate aminotransferase (AST) and alanine aminotransferase (ALT). In GH group, both AST and ALT levels after 32-week treatment were significantly lower than baseline values [21.50 (18.50, 30.50) vs 28.00 (21.75, 64.50) IU/L, P = 0.012; 24.00(19.75, 36.00) vs 31.50(23.50, 90.50) IU/L, P = 0.012; respectively), while no such changes could be obtained in placebo group.

Conclusion: GH replacement therapy can reduce LFC in patients with GHD and NAFLD, which may emphasize the need for prompt GH treatment in such specific patient population.