Elucidating Growth Hormone Dynamics at Stages of Progressive Nonalcoholic Fatty Liver Disease

Exclusion Criteria

• •Heavy alcohol use defined as consumption of \> 30mg daily for at least 3 consecutive months over the past 5 years
• •Type 1 diabetes, any use of insulin, or any use of other anti-diabetes medication except metformin or sulfonylurea. Individuals with Type 2 diabetes that is controlled by diet or by metformin and/or sulfonylurea will be eligible.
• •Use of any specific pharmacological treatments for NAFLD/NASH except vitamin E within the 3 months before screening visit.
• •Chronic systemic corticosteroid use in the ≤6 months prior to the baseline visit.
• •Chronic use of Actigall, methotrexate, amiodarone, or tamoxifen
• •Known diagnosis of alpha-1 antitrypsin deficiency, Wilson's disease, hemochromatosis, or autoimmune hepatitis
• •Use of GH or GHRH within the past 6 months
• •Change in lipid lowering or anti-hypertensive regimen within 2 months of screening
• •Hemoglobin \< 12.5 g/dL
• •Severe chronic illness judged by the investigator to present a contraindication to participation
• •History of hypopituitarism, head irradiation or any other condition known to affect the GH axis.
• •Use of testosterone or estrogen or progesterone unless physiologic stable testosterone use for at least 1 year prior to study entry
• •Weight loss surgery within 1 year before baseline. Weight loss surgery more than 1 year prior to baseline visit is permissible if no active weight loss (\<10% decrease in weight over past 6 months)
• •Lack of fluency in English and/or inability to complete the consent process in English.
• •Judge by the investigator to be inappropriate for the study for other reasons not detailed above.