Metabolic dysfunction-associated steatotic liver disease (MASLD; also known as nonalcoholic fatty liver disease) is a chronic condition associated with metabolic syndrome, a group of conditions that includes obesity, insulin resistance, hyperlipidaemia and cardiovascular disease. Primary growth hormone (GH) deficiency is associated with MASLD, and the decline in circulating levels of GH with weight gain might contribute to the development of MASLD. Raising endogenous GH secretion or administering GH replacement therapy in the context of MASLD enhances insulin-like growth factor 1 (IGF1) production and reduces steatosis and the severity of liver injury. GH and IGF1 indirectly control MASLD progression by regulating systemic metabolic function. Evidence supports the proposal that GH and IGF1 also have a direct role in regulating liver metabolism and health. This Review focuses on how GH acts on the hepatocyte in a sex-dependent manner to limit lipid accumulation, reduce stress, and promote survival and regeneration. In addition, we discuss how GH and IGF1 might regulate non-parenchymal cells of the liver to control inflammation and fibrosis, which have a major effect on hepatocyte survival and regeneration. Development of a better understanding of how GH and IGF1 coordinate the functions of specific, individual liver cell types might provide insight into the aetiology of MASLD initiation and progression and suggest novel approaches for the treatment of MASLD.

代谢功能障碍相关的脂肪肝病（MASLD；也称为非酒精性脂肪肝病）是一种与代谢综合征相关的慢性疾病，代谢综合征是一组疾病，包括肥胖、胰岛素抵抗、高脂血症和心血管疾病。原发性生长激素 (GH) 缺乏与 MASLD 相关，随着体重增加，GH 循环水平下降可能导致 MASLD 的发生。在 MASLD 的情况下提高内源性 GH 分泌或施用 GH 替代疗法可增强胰岛素样生长因子 1 (IGF1) 的产生，并减少脂肪变性和肝损伤的严重程度。 GH 和 IGF1 通过调节全身代谢功能间接控制 MASLD 进展。有证据支持 GH 和 IGF1 在调节肝脏代谢和健康方面也具有直接作用的观点。本综述重点关注 GH 如何以性别依赖性方式作用于肝细胞，以限制脂质积累、减轻压力并促进存活和再生。此外，我们还讨论了 GH 和 IGF1 如何调节肝脏非实质细胞以控制炎症和纤维化，这对肝细胞的存活和再生具有重大影响。更好地了解 GH 和 IGF1 如何协调特定的个体肝细胞类型的功能可能有助于深入了解 MASLD 的发生和进展的病因学，并提出治疗 MASLD 的新方法。