Liver fat in adults with GH deficiency: comparison to matched controls and the effect of GH replacement

CONTEXT: Existing data regarding the association between growth hormone deficiency (GHD) and liver fat content are conflicting. OBJECTIVE: We aimed i) to assess intrahepatocellular lipid (IHCL) content in hypopituitary adults with GHD compared to matched controls and ii) to evaluate the effect of growth hormone (GH) replacement on IHCL content. DESIGN: Cross-sectional comparison and controlled intervention study. PATIENTS, PARTICIPANTS: Cross-sectional comparison: 22 hypopituitary adults with GHD and 44 healthy controls matched for age, BMI, gender and ethnicity. Intervention study: 9 GHD patients starting GH replacement (GH Rx group), 9 GHD patients not starting replacement therapy (non-GH Rx group). INTERVENTION: Intervention study:GH replacement for 6 months in the GH Rx group, dosage was titrated to achieve normal IGF-1 levels. MAIN OUTCOME MEASURES: IHCL content determined by proton magnetic resonance spectroscopy (1 H MRS). RESULTS: Cross-sectional comparison: There was no difference in IHCL content between GHD patients and healthy controls (1.89% (0.30, 4.03) vs. 1.14% (0.22, 2.32); p=0.2), the prevalence of patients with hepatic steatosis (IHCL of ≥ 5.56%) was similar in the two groups (22.7% vs. 15.9%; chi square probability = 0.4). Intervention study: The change in IHCL content over 6 months did not differ between the GH Rx group and the non-GH Rx group (-0.63 ± 4.53% vs. +0.11 ± 1.46%; p=0.6). CONCLUSIONS: In our study liver fat content and the prevalence of hepatic steatosis did not differ between hypopituitary adults with GHD and matched controls. In GHD patients GH replacement had no effect on liver fat content.

Magna Charta and Parliament 1900-1914

In 1915 plans for the celebration of the 700th anniversary of Magna Carta had to be dropped following the outbreak of the First World War. Such celebrations marked a sense of Magna Carta as an event in the history of these islands. The usage of the term Magna Carta in Parliament in the run-up to the First World War, however, shows that its granting was not seen only as a significant historical event to be memorialised. During the period from 1900, opening with war in South Africa and ending in 1914 with war throughout Europe, the Great Charter was mentioned 85 times in Parliament. As a period marked by a lengthy constitutional crisis in 1909-11 and beset with problems in Ireland and the Empire, this seems like a good case study period to choose. This short paper attempts to analyse how and why it was invoked in Parliament in the years and what these various usages tell us about how Magna Carta was understood at the time.