Dysregulated growth hormone-insulin-like growth factor-1 axis in adults with metabolic dysfunction-associated...

A dysregulated growth hormone (GH)-insulin-like growth factor-1 (IGF-1) axis may contribute to the development and progression of metabolic dysfunction-associated steatotic liver disease (MASLD). However, the available evidence remains inconsistent.

We systematically searched PubMed and Scopus from database inception through 31 January 2026 to identify eligible observational studies assessing the association between circulating GH and IGF-1 levels and MASLD (diagnosed by liver biopsy or imaging). The primary outcome was the difference in circulating GH and IGF-1 levels between adults (age >18 years) with and without MASLD. Effect sizes were expressed as weighted mean differences (WMDs) with 95% confidence intervals (95%CI). A total of 18 observational studies were included. Fourteen studies (13,112 participants) measured circulating IGF-1 levels, five studies (7500 participants) measured circulating GH levels, and one study assessed both hormones. Individuals with MASLD had significantly lower circulating GH (random-effects WMD: -0.34 ng/ml; 95%CI, -0.61 to -0.07; I² = 81.5%) and IGF-1 (random-effects WMD: -24.85 ng/ml; 95%CI, -37.88 to -11.81; I² = 94.8%) levels than controls. Circulating IGF-1 levels were also lower in individuals with biopsy-confirmed metabolic dysfunction-associated steatohepatitis or advanced liver fibrosis (F2-F4 stages). Sensitivity analyses did not substantially alter these findings.

Circulating GH and IGF-1 levels are inversely associated with the presence and severity of MASLD. Further studies are needed to better understand the complex but existing link between a dysregulated (suppressed) GH-IGF-1 axis and MASLD.