IGF1 and fatty liver disease: Liver-specific deletion of GHR results in severely decreased circulating IGF-1 (~90%) with elevated GH (~300%), insulin resistance, hepatic steatosis [21, 22], alterations to most IGFBP's, increased adiponectin, and decreased body size (weight and length), despite increased local IGF-1 mRNA in extrahepatic tissues (such as skeletal muscle and adipose tissue) [22].