Transient Elastography and Controlled Attenuation Parameter (CAP) in the Assessment of Liver Steatosis in Severe Adult Growth Hormone Deficiency
Non-alcoholic fatty liver disease (NAFLD) is common in patients with growth hormone deficiency (GHD). Some noninvasive techniques have been used to quantify liver fat, such as the controlled attenuation parameter (CAP).Objective: To evaluate CAP as a tool to identify liver steatosis and its relation...
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Frontiers Media S.A.
2019-06-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fendo.2019.00364/full |
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| author | Adriana Claudia Lopes Carvalho-Furtado Daniela Mariano Carvalho-Louro Neysa Aparecida Tinoco Regattieri Marcelo Palmeira Rodrigues Maria Luiza Ricardo Nogueira Montenegro André Metzker Ferro Patrícia Souza Pirangi Luciana Ansaneli Naves |
| author_facet | Adriana Claudia Lopes Carvalho-Furtado Daniela Mariano Carvalho-Louro Neysa Aparecida Tinoco Regattieri Marcelo Palmeira Rodrigues Maria Luiza Ricardo Nogueira Montenegro André Metzker Ferro Patrícia Souza Pirangi Luciana Ansaneli Naves |
| author_sort | Adriana Claudia Lopes Carvalho-Furtado |
| collection | DOAJ |
| description | Non-alcoholic fatty liver disease (NAFLD) is common in patients with growth hormone deficiency (GHD). Some noninvasive techniques have been used to quantify liver fat, such as the controlled attenuation parameter (CAP).Objective: To evaluate CAP as a tool to identify liver steatosis and its relationship with different clinical and biochemical metabolic parameters in a group of patients with severe adult growth hormone deficiency (AGHD), and to compare the evolution of metabolic profiles after 6 months of human growth hormone (rhGH) replacement therapy in a subgroup of patients.Methods: Cross-sectional observational study at baseline of naive rhGH multiple pituitary hormonal deficiency (MPHD) hypopituitarism patients. A 6-month intervention clinical trial in a selected group of a non-randomized, non-controlled cohort was also applied.Results: Liver stiffness measurement (LSM) was normal in severe AGHD patients. CAP evaluation showed steatosis in 36.3% of baseline patients (8/22), associated with higher BMI, waist circumference, insulin, and alanine aminotransferase (ALT) levels. According to steatosis degree by CAP, child-onset growth hormone deficiency (CO-GHD) was graded as 68.75% (11/16) S0, 12.5% (2/16) S1, and 18.75% (3/16) S3, whereas AO-GHD was graded as 50% (3/6) S0, 16.66% (1/6) S2, and 33.33% S3. After 6 months of hrGH replacement, CAP measurements did not change significantly, neither on group without hepatic steatosis at baseline (194.4 ± 24.3 vs. 215.4 ± 51.3; p = 0.267) nor on the group with hepatic steatosis (297.2 ± 32.3 vs. 276.4 ± 27.8; p = 0.082). A significant improvement of body composition was observed only in the first group.Conclusions: We have demonstrated the importance of CAP as a non-invasive tool in the liver steatosis identification on hypopituitary patients. This method may be an important indicator of the severity of metabolic disorders in MPHD patients. In our study, no liver health modification in LSM at baseline or after 6 months of rhGH replacement was found. Longer studies can help to establish the potential repercussions of growth hormone replacement therapy on liver steatosis. |
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| language | English |
| last_indexed | 2024-12-19T20:34:02Z |
| publishDate | 2019-06-01 |
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| spelling | doaj.art-921ba14d9d6645e9a77fa4b7e08ebaf82022-12-21T20:06:36ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922019-06-011010.3389/fendo.2019.00364460783Transient Elastography and Controlled Attenuation Parameter (CAP) in the Assessment of Liver Steatosis in Severe Adult Growth Hormone DeficiencyAdriana Claudia Lopes Carvalho-Furtado0Daniela Mariano Carvalho-Louro1Neysa Aparecida Tinoco Regattieri2Marcelo Palmeira Rodrigues3Maria Luiza Ricardo Nogueira Montenegro4André Metzker Ferro5Patrícia Souza Pirangi6Luciana Ansaneli Naves7Endocrinology Unit, Instituto Hospital de Base, Brasília, BrazilGastroenterology Unit, Instituto Hospital de Base, Brasília, BrazilRadiology Unit, Faculty of Medicine, University of Brasilia, Brasília, BrazilPneumology Unity, Faculty of Medicine, University of Brasilia, Brasília, BrazilFaculty of Medicine, University of Brasilia, Brasília, BrazilFaculty of Medicine, University of Brasilia, Brasília, BrazilRadiology Unit, Faculty of Medicine, University of Brasilia, Brasília, BrazilEndocrinology Unit, Faculty of Medicine, University of Brasilia, Brasília, BrazilNon-alcoholic fatty liver disease (NAFLD) is common in patients with growth hormone deficiency (GHD). Some noninvasive techniques have been used to quantify liver fat, such as the controlled attenuation parameter (CAP).Objective: To evaluate CAP as a tool to identify liver steatosis and its relationship with different clinical and biochemical metabolic parameters in a group of patients with severe adult growth hormone deficiency (AGHD), and to compare the evolution of metabolic profiles after 6 months of human growth hormone (rhGH) replacement therapy in a subgroup of patients.Methods: Cross-sectional observational study at baseline of naive rhGH multiple pituitary hormonal deficiency (MPHD) hypopituitarism patients. A 6-month intervention clinical trial in a selected group of a non-randomized, non-controlled cohort was also applied.Results: Liver stiffness measurement (LSM) was normal in severe AGHD patients. CAP evaluation showed steatosis in 36.3% of baseline patients (8/22), associated with higher BMI, waist circumference, insulin, and alanine aminotransferase (ALT) levels. According to steatosis degree by CAP, child-onset growth hormone deficiency (CO-GHD) was graded as 68.75% (11/16) S0, 12.5% (2/16) S1, and 18.75% (3/16) S3, whereas AO-GHD was graded as 50% (3/6) S0, 16.66% (1/6) S2, and 33.33% S3. After 6 months of hrGH replacement, CAP measurements did not change significantly, neither on group without hepatic steatosis at baseline (194.4 ± 24.3 vs. 215.4 ± 51.3; p = 0.267) nor on the group with hepatic steatosis (297.2 ± 32.3 vs. 276.4 ± 27.8; p = 0.082). A significant improvement of body composition was observed only in the first group.Conclusions: We have demonstrated the importance of CAP as a non-invasive tool in the liver steatosis identification on hypopituitary patients. This method may be an important indicator of the severity of metabolic disorders in MPHD patients. In our study, no liver health modification in LSM at baseline or after 6 months of rhGH replacement was found. Longer studies can help to establish the potential repercussions of growth hormone replacement therapy on liver steatosis.https://www.frontiersin.org/article/10.3389/fendo.2019.00364/fulltransient elastographycontrolled atenuation parameterliver steatosismetabolic syndromeadult growth hormone deficiency (AGHD) |
| spellingShingle | Adriana Claudia Lopes Carvalho-Furtado Daniela Mariano Carvalho-Louro Neysa Aparecida Tinoco Regattieri Marcelo Palmeira Rodrigues Maria Luiza Ricardo Nogueira Montenegro André Metzker Ferro Patrícia Souza Pirangi Luciana Ansaneli Naves Transient Elastography and Controlled Attenuation Parameter (CAP) in the Assessment of Liver Steatosis in Severe Adult Growth Hormone Deficiency Frontiers in Endocrinology transient elastography controlled atenuation parameter liver steatosis metabolic syndrome adult growth hormone deficiency (AGHD) |
| title | Transient Elastography and Controlled Attenuation Parameter (CAP) in the Assessment of Liver Steatosis in Severe Adult Growth Hormone Deficiency |
| title_full | Transient Elastography and Controlled Attenuation Parameter (CAP) in the Assessment of Liver Steatosis in Severe Adult Growth Hormone Deficiency |
| title_fullStr | Transient Elastography and Controlled Attenuation Parameter (CAP) in the Assessment of Liver Steatosis in Severe Adult Growth Hormone Deficiency |
| title_full_unstemmed | Transient Elastography and Controlled Attenuation Parameter (CAP) in the Assessment of Liver Steatosis in Severe Adult Growth Hormone Deficiency |
| title_short | Transient Elastography and Controlled Attenuation Parameter (CAP) in the Assessment of Liver Steatosis in Severe Adult Growth Hormone Deficiency |
| title_sort | transient elastography and controlled attenuation parameter cap in the assessment of liver steatosis in severe adult growth hormone deficiency |
| topic | transient elastography controlled atenuation parameter liver steatosis metabolic syndrome adult growth hormone deficiency (AGHD) |
| url | https://www.frontiersin.org/article/10.3389/fendo.2019.00364/full |
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