Staff View: Transient elastography and controlled attenuation parameter (CAP) in the assessment of liver steatosis in severe adult growth hormone deficiency

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 relati...

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Main Authors:	Furtado, Adriana Claudia Lopes Carvalho, Louro, Daniela Mariano Carvalho, Regattieri, Neysa Aparecida Tinoco, Rodrigues, Marcelo Palmeira, Montenegro, Maria Luiza Ricardo Nogueira, Ferro, André Metzker, Pirangi, Patrícia Souza, Naves, Luciana Ansaneli
Format:	Artigo
Language:	Inglês
Published:	Frontiers 2020
Subjects:	Fígado gorduroso Somatotropina
Online Access:	https://repositorio.unb.br/handle/10482/37903 https://doi.org/10.3389/fendo.2019.00364
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spelling	ir-10482-379032020-12-13T21:45:55Z Transient elastography and controlled attenuation parameter (CAP) in the assessment of liver steatosis in severe adult growth hormone deficiency Furtado, Adriana Claudia Lopes Carvalho Louro, Daniela Mariano Carvalho Regattieri, Neysa Aparecida Tinoco Rodrigues, Marcelo Palmeira Montenegro, Maria Luiza Ricardo Nogueira Ferro, André Metzker Pirangi, Patrícia Souza Naves, Luciana Ansaneli Fígado gorduroso Somatotropina 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. 2020-05-28T19:10:50Z 2020-05-28T19:10:50Z 2019-06-19 Artigo FURTADO, Adriana Claudia Lopes Carvalho et al. Transient elastography and controlled attenuation parameter (CAP) in the assessment of liver steatosis in severe adult growth hormone deficiency. Frontiers in Endocrinology, v. 10, art. 364, jun. 2019. DOI: https://doi.org/10.3389/fendo.2019.00364. Disponível em: https://www.frontiersin.org/articles/10.3389/fendo.2019.00364/full. Acesso em: 28 maio 2020. https://repositorio.unb.br/handle/10482/37903 https://doi.org/10.3389/fendo.2019.00364 Inglês Acesso Aberto © 2019 Carvalho-Furtado, Carvalho-Louro, Regattieri, Rodrigues, Montenegro, Ferro, Pirangi and Naves. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. application/pdf Frontiers
institution	REPOSITORIO UNB
collection	REPOSITORIO UNB
language	Inglês
topic	Fígado gorduroso Somatotropina
spellingShingle	Fígado gorduroso Somatotropina Furtado, Adriana Claudia Lopes Carvalho Louro, Daniela Mariano Carvalho Regattieri, Neysa Aparecida Tinoco Rodrigues, Marcelo Palmeira Montenegro, Maria Luiza Ricardo Nogueira Ferro, André Metzker Pirangi, Patrícia Souza Naves, Luciana Ansaneli Transient elastography and controlled attenuation parameter (CAP) in the assessment of liver steatosis in severe adult growth hormone deficiency
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.
format	Artigo
author	Furtado, Adriana Claudia Lopes Carvalho Louro, Daniela Mariano Carvalho Regattieri, Neysa Aparecida Tinoco Rodrigues, Marcelo Palmeira Montenegro, Maria Luiza Ricardo Nogueira Ferro, André Metzker Pirangi, Patrícia Souza Naves, Luciana Ansaneli
author_sort	Furtado, Adriana Claudia Lopes Carvalho
title	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_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_sort	transient elastography and controlled attenuation parameter (cap) in the assessment of liver steatosis in severe adult growth hormone deficiency
publisher	Frontiers
publishDate	2020
url	https://repositorio.unb.br/handle/10482/37903 https://doi.org/10.3389/fendo.2019.00364
_version_	1686784747398758400
score	13.657419

Transient elastography and controlled attenuation parameter (CAP) in the assessment of liver steatosis in severe adult growth hormone deficiency

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