Hormonal
Ghrelin levels, specifically the ratio of unacylated to acylated ghrelin, are altered in NAFLD patients, with decreased plasma unacylated/acylated ghrelin ratio and increased hypothalamic acylated ghrelin expression correlating with insulin resistance and NAFLD severity.
Research indicates that ghrelin signaling is disrupted in NAFLD, with specific changes in ghrelin ratios correlating with insulin resistance. While ghrelin antagonists like pegvisomant are being studied, they are not yet established treatments. Current clinical focus remains on GLP-1 agonists for managing NAFLD.
A hypothesis that Ghr might be involved in NAFLD was proposed by Liu et al. using a murine NAFLD model... they observed that a plasma decrease in Unacylated Ghr/Acylated Ghr ratio in combination with the hypothalamic over-expression of Acylated Ghr and its receptor could be associated with NAFLD due to their positive correlations (R2 = 0.56 – 0.85, p <0.05) with homeostatic model assessment insulin resistance (HOMA-IR).
Why this rating
Evidence comes from murine models and cross-sectional studies; human clinical trials for ghrelin antagonists are noted as needing further investigation.
Source
Hunger & satiety signals: another key mechanism involved in the NAFLD pathway
Iván López-Méndez et al. · Frontiers in Endocrinology · 2023
DOI 10.3389/fendo.2023.1213372
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