Dysregulated growth hormone-insulin-like growth factor-1 axis in adults with metabolic dysfunction-associated steatotic liver disease: a meta-analysis.
Dario Messetti, Alessandro Mantovani, Riccardo Morandin et al.
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In 30 seconds
This systematic review and meta-analysis examined observational evidence on circulating growth hormone (GH) and insulin-like growth factor-1 (IGF-1) in adults with and without metabolic dysfunction-associated steatotic liver disease (MASLD). Across 18 studies, MASLD was associated with lower levels of both hormones than in controls: GH weighted mean difference (WMD) −0.34 ng/ml (95% CI, −0.61 to −0.07) and IGF-1 WMD −24.85 ng/ml (95% CI, −37.88 to −11.81). IGF-1 was also lower with biopsy-confirmed steatohepatitis or advanced fibrosis. These observational findings indicate association, not causation.
Key findings
- Across five studies measuring GH, MASLD was associated with lower levels than controls (WMD: −0.34 ng/ml; 95% CI, −0.61 to −0.07; I² = 81.5%).
- Across 14 studies measuring IGF-1, levels were lower in MASLD (WMD: −24.85 ng/ml; 95% CI, −37.88 to −11.81; I² = 94.8%).
- IGF-1 levels were also lower in participants with biopsy-confirmed steatohepatitis or advanced liver fibrosis (F2–F4).
Why it matters
The findings link a suppressed GH–IGF-1 axis with MASLD presence and, for IGF-1, with more severe liver disease. This may help frame questions about endocrine and metabolic features accompanying MASLD, while the substantial between-study heterogeneity and observational evidence mean the results do not establish whether hormonal changes contribute to disease or result from it.
What to keep in mind
The evidence is observational, and heterogeneity was high for both GH and IGF-1 estimates (I² = 81.5% and 94.8%, respectively), limiting causal interpretation and consistency.